Prognostic factors for patients in postoperative brain metastases from surgically resected non-small cell lung cancer

• Published in: International journal of clinical oncology 2014-02, Vol.19 (1), p.50-56
• Main Authors: Sakamoto, Jin, Sonobe, Makoto, Kobayashi, Masashi, Ishikawa, Masashi, Kikuchi, Ryutaro, Nakajima, Daisuke, Yamada, Tetsu, Nakayama, Ei, Takahashi, Tsuyoshi, Sato, Toshihiko, Chen, Fengshi, Bando, Toru, Date, Hiroshi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brain Neoplasms - pathology; Brain Neoplasms - secondary; Cancer Research; Cancer surgery; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; Combined Modality Therapy; Female; Humans; Lung cancer; Male; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Oncology; Original Article; Postoperative Period; Prognosis; Retrospective Studies; Surgical Oncology; Survival Rate; Treatment Outcome
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-012-0503-8

Background Postoperative recurrence in non-small cell lung cancer (NSCLC) reduces the life expectancy of patients. In this retrospective study, we investigated the prognostic factors in patients with postoperative brain metastases from surgical resected non-small cell lung cancer (NSCLC). Methods We conducted a retrospective chart review of patients who had undergone resection for NSCLC between April 2004 and February 2009 and found 65 had experienced postoperative brain metastases by March 2010. We reviewed these patients for clinicopathological information, treatments and responses to treatment, and overall survival. Results The 5-year survival rate after the diagnosis of brain metastases was 15.4 %. Significantly favorable prognostic factors for patients after a diagnosis of brain metastases included female gender, adenocarcinoma, a small number (1–3) of brain metastases, no extracranial metastasis at the diagnosis of brain metastases, radiation treatment (whole-brain radiation and/or stereotactic irradiation), and local treatment [stereotactic irradiation and/or surgical operation (craniotomy)]. Furthermore, in patients with only brain metastases as the postoperative initial recurrence, the favorable positive prognostic factors included a small number (1–3) of brain metastases, adjuvant chemotherapy, chemotherapy (including adjuvant and other chemotherapy and excluding epidermal growth factor receptor–tyrosine kinase inhibitors), and local treatment. Conclusions Our study found that the foregoing clinical characteristics in postoperative brain metastases and the administration of treatment contributed to patient life expectancy.