Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Int J Clin Oncol. 2014 Feb;19(1):50-6. doi: 10.1007/s10147-012-0503-8. Epub 2012 Dec 14.
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).
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.
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.
Our study found that the foregoing clinical characteristics in postoperative brain metastases and the administration of treatment contributed to patient life expectancy.
非小细胞肺癌(NSCLC)术后复发会降低患者的预期寿命。在这项回顾性研究中,我们研究了手术切除的非小细胞肺癌(NSCLC)术后发生脑转移患者的预后因素。
我们对 2004 年 4 月至 2009 年 2 月期间接受 NSCLC 切除术的患者进行了回顾性图表审查,并发现截至 2010 年 3 月,有 65 例患者术后发生脑转移。我们对这些患者的临床病理信息、治疗和治疗反应以及总生存情况进行了回顾。
脑转移诊断后的 5 年生存率为 15.4%。脑转移诊断后对患者预后有显著有利影响的因素包括女性、腺癌、脑转移灶数量较少(1-3 个)、脑转移诊断时无颅外转移、放疗(全脑放疗和/或立体定向放疗)和局部治疗[立体定向放疗和/或手术(开颅术)]。此外,在仅以脑转移为术后首发复发的患者中,有利的阳性预后因素包括脑转移灶数量较少(1-3 个)、辅助化疗、化疗(包括辅助化疗和其他化疗,但不包括表皮生长因子受体酪氨酸激酶抑制剂)和局部治疗。
我们的研究发现,术后脑转移和治疗管理中的上述临床特征有助于提高患者的预期寿命。