Baysungur Volkan, Tezel Çagatay, Kıral Hakan, Gürer Bora, Kanbur Serda Metin, Alpay Levent, Doğruyol Talha, Gürer Deniz, Yılmaz Hakan
Department of Thoracic Surgery, Süreyyapaşa Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Department of Neurosurgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Apr 24;27(2):192-198. doi: 10.5606/tgkdc.dergisi.2019.15427. eCollection 2019 Apr.
This study aims to investigate the factors affecting the survival of operated non-small cell lung cancer patients with synchronous brain metastasis.
Clinical outcomes of a total of 16 patients (14 males, 2 females; mean age 60 years; range, 41 to 71 years) who were diagnosed with non-small cell lung cancer and concomitant solitary/oligo brain metastasis and who underwent an intervention primarily for cranium, followed by lung resection in our clinic between January 2012 and January 2016 were retrospectively analyzed. Cranial surgery or gamma-knife radiosurgery was performed in the treatment of brain metastases.
Twelve patients with solitary brain metastasis underwent cranial surgery, while four patients with solitary/oligo metastases underwent gamma-knife radiosurgery prior to pulmonary resection. Definitive pathological examination revealed adenocarcinoma in 13 patients and squamous-cell lung carcinoma in three patients. Mean survival time was 15.3±8.6 months. One-year and two-year survival rates were 56.2% and 32%, respectively. The number of brain metastases, treatment type, tumor cell type, resection type, and status of lymph nodes were not statistically significantly associated with survival (p>0.05).
Cranial surgery or gamma-knife radiosurgery followed by aggressive lung resection can be effectively applied in selected non-small cell lung cancer patients with synchronous brain metastasis. However, the suitability of the primary tumor and brain metastases for complete resection is of utmost importance in patient selection.
本研究旨在调查影响手术治疗的非小细胞肺癌合并同步脑转移患者生存的因素。
回顾性分析2012年1月至2016年1月期间在我院诊断为非小细胞肺癌并伴有孤立性/寡发性脑转移且主要因颅骨病变接受干预，随后进行肺切除术的16例患者（14例男性，2例女性；平均年龄60岁；范围41至71岁）的临床结局。脑转移瘤的治疗采用开颅手术或伽玛刀放射外科手术。
12例孤立性脑转移患者接受了开颅手术，4例孤立性/寡发性转移患者在肺切除术前接受了伽玛刀放射外科手术。最终病理检查显示13例为腺癌，3例为肺鳞状细胞癌。平均生存时间为15.3±8.6个月。1年和2年生存率分别为56.2%和32%。脑转移瘤数量、治疗类型、肿瘤细胞类型、切除类型和淋巴结状态与生存无统计学显著相关性（p>0.05）。
对于选定的非小细胞肺癌合并同步脑转移患者，可有效应用开颅手术或伽玛刀放射外科手术，随后进行积极的肺切除术。然而，在患者选择中，原发肿瘤和脑转移瘤能否完全切除至关重要。
