Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.
Eur J Cancer Prev. 2023 Sep 1;32(5):498-511. doi: 10.1097/CEJ.0000000000000790. Epub 2023 Feb 20.
Brain is a common metastasis site in lung cancer patients. However, homogeneous and heterogeneous risk/prognostic factors of brain metastasis for lung cancer patients have not been comprehensively elucidated. This study aimed to explore the brain metastasis risk and prognostic factors in lung cancer patients using the Surveillance, Epidemiology, and End Results (SEER) database.
Lung cancer data were downloaded from SEER database to investigate risk factors for developing brain metastasis using logistic regression analysis. Univariate and multivariate Cox analyses were used to identify potential prognostic factors. Kaplan-Meier analysis was conducted to evaluate the survival. Propensity score matching was conducted to eliminate baseline differences between two groups.
A total of 10 818 (14.1%) patients with brain metastasis were diagnosed among 76 483 lung cancer patients. For non-small-cell lung carcinoma (NSCLC), distant liver/bone/lymph node metastases, higher T, N stages were risk factors. Black race, bone metastases and distant lymph node metastases and T4 were brain metastasis risk factors for SCLC patients. Cox analysis suggested that older age, male, primary lesion at main bronchus, liver/ bone/distant lymph node metastases, T2-4, N1-3, no surgery/chemotherapy/radiotherapy were associated with worse prognosis of NSCLC-brain metastasis patients. Age older than 80, liver/bone metastases, without radiotherapy and chemotherapy were associated with worse prognosis of SCLC-brain metastasis patients. Surgery of primary site could prolong the overall survival (OS) of NSCLC patients with brain metastasis, but not SCLC.
In this study, we analyzed the homogeneous and heterogeneous risk/prognostic factors of brain metastasis in lung cancer patients. What is more, our results showed that surgery of primary site was associated with longer OS of NSCLC patients with brain metastasis.
脑是肺癌患者常见的转移部位。然而，肺癌患者脑转移的同质和异质风险/预后因素尚未得到全面阐明。本研究旨在利用监测、流行病学和最终结果（SEER）数据库探讨肺癌患者脑转移的风险和预后因素。
从 SEER 数据库下载肺癌数据，使用逻辑回归分析探讨脑转移的风险因素。采用单因素和多因素 Cox 分析确定潜在的预后因素。采用 Kaplan-Meier 分析评估生存情况。采用倾向评分匹配消除两组间的基线差异。
在 76483 例肺癌患者中，共诊断出 10818 例（14.1%）脑转移患者。对于非小细胞肺癌（NSCLC），远处肝/骨/淋巴结转移、较高的 T、N 期是风险因素。黑人、骨转移和远处淋巴结转移以及 T4 是小细胞肺癌患者脑转移的风险因素。Cox 分析表明，年龄较大、男性、主支气管原发灶、肝/骨/远处淋巴结转移、T2-4、N1-3、无手术/化疗/放疗与 NSCLC-脑转移患者的预后较差相关。年龄大于 80 岁、肝/骨转移、无放疗和化疗与 SCLC-脑转移患者的预后较差相关。对原发灶进行手术可延长 NSCLC 脑转移患者的总生存期（OS），但对 SCLC 无影响。
在这项研究中，我们分析了肺癌患者脑转移的同质和异质风险/预后因素。此外，我们的研究结果表明，对原发灶进行手术与 NSCLC 脑转移患者的 OS 延长相关。
