Kanou Takashi, Okami Jiro, Tokunaga Toshiteru, Fujiwara Ayako, Ishida Daisuke, Kuno Hidenori, Higashiyama Masahiko
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3 Nakamichi 1-chome, Higashinari-ku, Osaka, 537-8511, Japan,
Surg Today. 2014 Jul;44(7):1321-7. doi: 10.1007/s00595-014-0895-3. Epub 2014 Apr 20.
Several reports have described extended survival after aggressive surgical treatment for non-small cell lung cancer (NSCLC) and synchronous brain metastasis. This retrospective analysis assesses the prognostic factors in this population.
We reviewed retrospectively the medical records of 29 patients with synchronous brain metastasis from NSCLC, who underwent surgical treatment in our institution between 1980 and 2008. All patients underwent chest surgery to remove the primary lesion. The impact of several variables on survival was assessed.
The median follow-up period was 9.6 months and the 5-year survival rate from the time of lung cancer resection was 20.6 %. Univariate analysis demonstrated that the carcinoembryonic antigen (CEA) level, primary tumor size, and the presence of lymph node involvement were predictive of overall survival (p < 0.05). Multivariate analysis also identified those factors to be independent favorable prognostic factors.
Although the survival of patients with brain metastasis from non-small cell lung cancer remains poor, surgical resection may benefit a select group of patients, particularly those with a normal CEA level, small tumor size, and node-negative status.
多项报告描述了非小细胞肺癌（NSCLC）合并同步脑转移患者在接受积极手术治疗后生存期延长的情况。本回顾性分析评估了该人群的预后因素。
我们回顾性分析了1980年至2008年间在我院接受手术治疗的29例NSCLC合并同步脑转移患者的病历。所有患者均接受了胸部手术以切除原发灶。评估了多个变量对生存期的影响。
中位随访期为9.6个月，肺癌切除术后的5年生存率为20.6%。单因素分析表明，癌胚抗原（CEA）水平、原发肿瘤大小和淋巴结受累情况可预测总生存期（p<0.05）。多因素分析也确定这些因素为独立的有利预后因素。
尽管非小细胞肺癌脑转移患者的生存期仍然较差，但手术切除可能使一部分患者受益，特别是那些CEA水平正常、肿瘤较小且无淋巴结转移的患者。
