Non-small cell lung cancer (NSCLCA): Does the size of the tumor and the patient’s age predict brain metastases?

Abstract

Listen

Translate article

7318 Background: Many studies have demonstrated the prognostic importance of tumor size in the early stages of NSCLCA and the effect of age on the outcome; however, no study has looked at the association between brain metastases and the size of the tumor or the age of the patient. Subjects and Methods: We retrospectively analyzed 251 cases that were diagnosed with NSCLCA over a period of five years (1999–2003) in two institutions. We looked at many aspects at the presentation of the disease in an effort to predict brain metastases: age of the patients, size of the tumor, hilar involvement, pleural effusion, and pathology of the tumor. 88 patients (35%) were ≤60 years old. 82 patients (32.7%)had a tumor size ≤3 cm, 146 (58%) had tumor >3 cm, 16 (6.4%) had massive plural effusion, and 7 (2.8%) were presented with lung collapse. Hilar and pleural involvement occurred in 127 (51%) and 83 patients (33%), respectively. Histology showed adenocarcenoma in 194 patients (77%), squamous cell carcinoma in 51 (20%), and large cell carcinoma in 6 (3%). Results: A total of 44 cases of brain metastasis were found at the time of diagnosis, and of these, 24 (55%) were <60 years old. Compared to the patients >60 years old, there was a statistically significant increase in the incidence of brain metastasis by using chi-squar test (p=0.0029), and by using linear regression analysis there was a high significance of age predicting brain metastases (p<0.05). There was no significance when comparing the incidence of brain metastases to a primary tumor size ≤3 cm, (p=0.2668), Hilar involvement (p= 0.2147), or pleural effusion (p=0.3683). However, there was a statistical significance when comparing the incidence of brain mets with the pathology (adenocarcenoma) of the tumor (p=0.01). Conclusion: Our analysis suggests that younger pts. (≤60 years) have a higher chance to present with brain mets then older pts. (>60), the pathology of the tumor (adenocarcenoma) has a high chance to metastasize, and the size of the tumor does not predict brain mets. No significant financial relationships to disclose.