期刊
FRONTIERS IN ONCOLOGY
卷 12, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2022.951805
关键词
NSCLC; metastasis; brain metastasis; survival; resectable; surgery
类别
资金
- Bender Stiftung
- Sander Stiftung
- Erich and Gertrud Roggenbuck Stiftung
Non-small cell lung cancer is the leading cause of cancer-related death globally, with an increasing incidence of brain metastases in NSCLC patients. This study identified systemic metastatic load and number of brain metastases as significant factors affecting overall survival in resectable NSCLC patients. Factors such as age, absence of other systemic metastases, and number of brain metastases were found to impact survival outcomes.
Non-small cell lung cancer (NSCLC) is currently the leading cause of cancer-related death worldwide, and the incidence of brain metastases (BM) in NSCLC patients is continuously increasing. The recent improvements of systemic treatment in NSCLC necessitate continuous updates on prognostic subgroups and factors determining overall survival (OS). In order to improve clinical decision-making in tumor boards, we investigated the clinical determinants affecting survival in patients with resectable NSCLC BM. A retrospective analysis was conducted of NSCLC patients with surgically resectable BM treated in our institution between 01/2015 and 12/2020. The relevant clinical factors affecting survival identified by univariate analysis were included in a multivariate logistic regression model. Overall, 264 patients were identified, with a mean age of 62.39 +/- 9.98 years at the initial diagnosis of NSCLC BM and OS of 23.22 +/- 1.71 months. The factors that significantly affected OS from the time of primary tumor diagnosis included the systemic metastatic load (median: 28.40 +/- 4.82 vs. 40.93 +/- 11.18 months, p = 0.021) as well as a number of BM <2 (median: 17.20 +/- 2.52 vs. 32.53 +/- 3.35 months, p = 0.014). When adjusted for survival time after neurosurgical intervention, a significant survival benefit was found in patients <60 years (median 16.13 +/- 3.85 vs. 9.20 +/- 1.39 months, p = 0.011) and, among others, patients without any concurrent systemic metastases at time of NSCLC BM diagnosis. Our data shows that the number of BM (singular/solitary), the Karnofsky Performance Status, gender, and age but not localization (infra-/supratentorial), mass-edema index or time to BM occurrence impact OS, and postsurgical survival in NSCLC BM patients. Additionally, our study shows that patients in prognostically favorable clinical subgroups an OS, which differs significantly from current statements in literature. The described clinically relevant factors may improve the understanding of the risks and the course of this disease and Faid future clinical decision making in tumor boards.
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