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Prognostic factors for cases with no extracranial metastasis in whom brain metastasis is detected after resection of non-small cell lung cancer

 Mi Kyung Bae  ;  Woo Sik Yu  ;  Go Eun Byun  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Kyung Young Chung 
 LUNG CANCER, Vol.88(2) : 195-200, 2015 
Journal Title
Issue Date
Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Brain/pathology* ; Brain/radiation effects ; Brain Neoplasms/pathology* ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/secondary* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Female ; Humans ; Lung Neoplasms/pathology* ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Prognosis ; Radiosurgery/methods ; Retrospective Studies ; Treatment Outcome
Brain metastasis ; Non-small cell lung cancer ; Prognosis ; Recurrence
OBJECTIVES: This study aimed to determine prognostic factors associated with postrecurrence survival in cases with postoperative brain metastasis but with no extracranial metastasis in non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: Between 1992 and 2012, a total of 2832 patients underwent surgical resection for NSCLC. Among those, 86 patients had postoperative brain metastasis as the initial recurrence. Those patients were retrospectively reviewed. RESULTS: The median follow-up time after the initial lung resection was 24.0 months (range, 2.0-126.0 months). The median overall survival after initial lung cancer resection was 25.0 months and the median overall postrecurrence survival was 11 months. An initial lesion of adenocarcinoma (hazard ratio, 0.548; 95% confidence interval, 0.318 to 0.946; p=0.031), non-pneumonectomy, and a disease-free interval longer than 10.0 months (hazard ratio, 0.565; 95% confidence interval, 0.321-0.995; p=0.048) from the initial lung resection to the diagnosis of brain metastasis positively related to a good postrecurrence survival. Solitary brain metastasis and a size of less than 3 cm for the largest brain lesion were also positive factors for postrecurrence survival. Systemic chemotherapy for brain metastasis (hazard ratio, 0.356; 95% confidence interval, 0.189-0.670; p=0.001) and local treatment of surgery and/or stereotactic radiosurgery (SRS) for brain lesions (hazard ratio, 0.321; 95% confidence interval, 0.138-0.747; p=0.008) were positive factors for better postrecurrence survival. CONCLUSION: In patients with brain metastasis after resection for NSCLC with no extracranial metastasis, adenocarcinoma histologic type, longer disease-free interval, systemic chemotherapy for brain metastasis and local treatment of surgery and/or SRS for brain metastasis are independent positive prognostic factors for postrecurrence survival.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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