Incidence of Brain Metastasis at the Initial Diagnosis of Lung Squamous Cell Carcinoma on the Basis of Stage, Excluding Brain Metastasis

Current National Comprehensive Cancer Network guidelines recommend routine brain magnetic resonance imaging (MRI) screening in patients with stage II to IV non–small cell carcinoma, regardless of histological subtype. This recommendation might not be universally applicable, however, because brain me...

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Bibliographic Details
Published in:Journal of thoracic oncology 2016-03, Vol.11 (3), p.426-431
Main Authors: Lee, Hyun, Jeong, Suk Hyeon, Jeong, Byeong-Ho, Park, Hye Yun, Lee, Kyung-Jong, Um, Sang-Won, Kwon, O Jung, Kim, Hojoong
Format: Article
Language:English
Subjects:
Aged
Brain metastasis
Brain Neoplasms - secondary
Carcinoma, Squamous Cell - pathology
Female
Humans
Incidence
Lung Neoplasms - pathology
Male
Neoplasm Staging
Non–small cell lung carcinoma
Prospective Studies
Squamous cell carcinoma
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Summary:Current National Comprehensive Cancer Network guidelines recommend routine brain magnetic resonance imaging (MRI) screening in patients with stage II to IV non–small cell carcinoma, regardless of histological subtype. This recommendation might not be universally applicable, however, because brain metastasis (BM) is seen less frequently in patients with lung squamous cell carcinoma (SCC) than in those with a histological diagnosis of nonsquamous cell carcinoma. The cases of 564 patients with lung SCC in our institution between January 2012 and December 2013 were reviewed prospectively for comprehensive staging. All subjects' lung SCC, but not their BM, was staged on the basis of the seventh edition of the guidelines of the American Joint Committee on Cancer. We evaluated the incidence of BM across the stages and clinical factors associated with BM. Of the 564 patients, 28 (5.0%) had BM. BM did not occur in patients with stage Ia or Ib disease; however, it increased significantly as the disease progressed from stage IIa to IV (p < 0.001, trend test). Multivariate analysis showed that tumor involvement in N3 lymph nodes and distant metastasis other than BM (M1b) was independently associated with the development of BM. Routine brain MRI screening in patients with lung SCC in stage II to IV can help to evaluate asymptomatic BM. By contrast, we did not find any evidence supporting routine brain MRI screening in patients with stage I disease.
ISSN:1556-0864
1556-1380
DOI:10.1016/j.jtho.2015.11.007