Yuksel Cabir, Bozkurt Melih, Yenigun Bulent Mustafa, Enon Serkan, Ozkan Murat, Kose S Kenan, Cangir Ayten Kayı
Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
Thorac Cardiovasc Surg. 2014 Oct;62(7):605-11. doi: 10.1055/s-0033-1360477. Epub 2013 Dec 5.
The reported median survival in patients with non-small cell lung cancer (NSCLC) metastases to the brain varies from 3 to 12 months with combined treatment modalities. Bifocal surgical resection of synchronous brain metastasis and primary NSCLC has not been reported widely, and there have been only a small number of articles published in the literature. The aim of this retrospective study was to evaluate the prognostic factors among patients undergoing bifocal surgical resection.
We retrospectively analyzed 28 patients who had a solitary metastatic brain lesion at the time of diagnosis, and underwent synchronous surgical resection of the brain metastasis and primary lung tumor. Survival time was measured in all the patients from the date of craniotomy until death or the most recent date of follow-up for those still surviving.
Mean age was 53 years. The mean length of follow-up was 23.6 (4-69) months. The overall survival rates were 79, 42, and 8% at the 1st, 2nd, and 5th years, respectively. The median length of survival was 24 ± 3.8 months. The median survival was found to be statistically significantly lower for the stage T3 tumors when compared with both stage T1 and T2 tumors (p = 0.037).
NSCLC patients with resectable solitary cranial metastasis, low locoregional stage (stages IA, IB, IIA) in which T3 status is counted out, with no mediastinal lymph node involvement or any other extrathoracic spread will mostly benefit from consecutive complete resection of both tumors and are supposed to have a better survival.
据报道，采用联合治疗方式时，非小细胞肺癌（NSCLC）脑转移患者的中位生存期为3至12个月。同步脑转移和原发性NSCLC的双灶手术切除尚未得到广泛报道，文献中仅发表了少数文章。本回顾性研究的目的是评估接受双灶手术切除患者的预后因素。
我们回顾性分析了28例诊断时存在孤立性脑转移瘤且接受了脑转移瘤和原发性肺肿瘤同步手术切除的患者。从开颅日期开始测量所有患者的生存时间，直至死亡或仍存活患者的最近随访日期。
平均年龄为53岁。平均随访时间为23.6（4 - 69）个月。第1年、第2年和第5年的总生存率分别为79%、42%和8%。中位生存时间为24±3.8个月。与T1期和T2期肿瘤相比，T3期肿瘤的中位生存期在统计学上显著更低（p = 0.037）。
可切除的孤立性颅转移、局部区域分期低（IA期、IB期、IIA期，排除T3状态）、无纵隔淋巴结受累或任何其他胸外转移的NSCLC患者，大多将从两个肿瘤的连续完全切除中获益，并且预期有更好的生存。
