Surgery of primary lung cancer with oligometastatic m1b synchronous single brain metastasis: analysis of 37 cases
Abstract
BACKGROUND: At the time of diagnosis, lung cancer has often metastasized already. Brain metastases, however, are associated with a poor prognosis (median survival of less than 1 year). We evaluated the changes of the median survival after resection of the cerebral metastases and primary non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between January 1999 and December 2009, 37 patients (22 men, 15 women; median age: 55.64 years; age range: 38-72 years) underwent surgery for primary NSCLC after craniotomy and removal of the synchronous single brain metastasis. The overall survival was evaluated and risk factors identified. RESULTS: Mediastinal lymph node involvement was excluded with mediastinoscopy in 26 of the 37 patients. Postoperative N-stage was N0, N1, and N2 in 16 (43%), 10 (27%), and 11 (30%) patients, respectively. Histology was squamous cell carcinoma in 10 (27%), adenocarcinoma in 20 (54%), and large cell carcinoma in 7 (19%). The employed type of resection was anatomical segmentectomy in 6 and lobectomy in 31 patients. The 30-day mortality was 0% and postoperative complications occurred in 12 patients only (32%). The overall 1 and 2 years survival were 62 and 24%, respectively. None of the factors age, sex, tumor histology, primary location of the tumor, type of resection, adjuvant chemotherapy, or nodal status affected survival in the univariate analysis. CONCLUSIONS: The oncologic lung resection of NSCLC after the resection of a single brain metastasis can be implemented without an increased risk of complications or mortality. Despite the stage IV disease, the median survival appears encouraging.
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In that retrospective series, nodal status did not affect survival on univariate analysis.
“It is to note that in this series nodal status did not affect survival on univariate analysis.”
From Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2016) · cites this paper as [174]
In a retrospective study of 37 patients with synchronous NSCLC and brain metastasis both surgically excised, 1-year OS was 62% and 2-year OS was 24%.
“In a retrospective study of 37 patients with synchronous NSCLC and brain metastasis, which were both surgically excised [174], the 1-and 2-year OS rates were 62% and 24%, respectively.”
From Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2016) · cites this paper as [174]
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- Authors
- Welter, S., Chalvatzoulis, E., Christof, D., Theegarten, D., Stamatis, G., & Cheufou, D.
- Affiliations
- Ruhrlandklinik (DE)
- University of Duisburg-Essen (DE)
- Corresponding author
- Cheufou, Danjouma
- Venue
- The Thoracic and Cardiovascular Surgeon
- Publisher
- Georg Thieme Verlag KG
- Published
- 2014-08-19
- Volume
- 62
- Issue
- 07
- Pages
- 612-615
- ISSN
- 0171-6425 (ISSN-L)
- 1439-1902
- OpenAlex
- W1989025265
- Cited by
- 20
- References
- 0
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 3
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Thoracic and Cardiovascular Surgeon (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Brain Metastases and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Metastasis and carcinoma case studies
- Keywords
- non-small cell lung cancer, brain metastases, synchronous metastases, oligometastatic disease, craniotomy, lobectomy, segmentectomy, overall survival, postoperative complications, adjuvant chemotherapy, prognostic factors
- MeSH terms
- Adult, Aged, Brain Neoplasms, Carcinoma, Non-Small-Cell Lung, Craniotomy, Female, Follow-Up Studies, Germany, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Pneumonectomy, Postoperative Complications, Retrospective Studies, Incidence, Survival Rate, Treatment Outcome, Neurosurgical Procedures
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