Lonjon M, Paquis P, Michiels J F, Frenay M, Bensadoun R J, Chatel M, Roche J L, Grellier P
Service de Neurochirurgie, Hôpital Pasteur, Nice.
Rev Neurol (Paris). 1994;150(3):216-21.
The most frequent brain metastasis originates from a lung cancer. About half of them are unique. We report a series of 36 patients with lung cancer, operated for a single brain lesion. The mean age was 57.6 years, most (83.3%) were male. Most of the metastases originated from a primary adenocarcinoma (52.8%), in 10 patients (27.8%) from an epidermoid carcinoma, in 4 patients (11.1%) from a small cell carcinoma and in 3 patients from a mixed lesion. The metastatic lesion was detected before the primary lesion in 20 cases (55.5%). The mean post-operative survival was 9.6 months. 36% were alive one year after surgical treatment. We evaluated our clinical findings, histopathological studies and the type of surgical and medical post-operative management, at the cerebral and pulmonary level, in order to make a possible prognosis. In our series we found that only post-operative clinical status (Karnofsky score) and the post-operative neurological grading (Order classification) were significant factors (p < 0.001) to determine survival time.
最常见的脑转移瘤起源于肺癌。其中约一半为单发。我们报告了一组36例因单一脑病变接受手术的肺癌患者。平均年龄为57.6岁,大多数(83.3%)为男性。大多数转移瘤起源于原发性腺癌(52.8%),10例(27.8%)起源于表皮样癌,4例(11.1%)起源于小细胞癌,3例起源于混合性病变。20例(55.5%)的转移瘤在原发性病变之前被检测到。术后平均生存期为9.6个月。36%的患者在手术治疗一年后仍存活。我们评估了我们的临床发现、组织病理学研究以及脑和肺水平的手术及术后药物治疗管理类型,以便做出可能的预后判断。在我们的系列研究中,我们发现只有术后临床状态(卡诺夫斯基评分)和术后神经学分级(奥尔德分类)是决定生存时间的重要因素(p<0.001)。