P04 Clinical and Pathological Characteristics of NSCLC and the Relationship with the Development of Brain Metastases

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non–small cell lung cancer (NSCLC) is one of the main causes of brain metastases. Most cases are diagnosed at an advanced stage, which elevates the risk for the detection of brain metastases. It is imperative to establish easily accessible criteria to determine clinical and pathological factors that could predispose to the development brain metastases, even before symptoms appear. Such a study has not yet been executed, and with increasing restrictions to basic diagnostic methods and follow-up strategies, clinical stratification becomes an alternative our clinicians can use in their daily practice. To recognize clinical and pathologic characteristics of patients with NSCLC and their relationship with the development of brain metastasis, we reviewed medical records at the Department of Medical Records at the Dr. Luis Razetti Oncology Institute, between 2008 and 2016, searching for patients with NSCLC describing their clinical and pathologic characteristics. The presence of brain metastasis was associated according to the other variables through the non-parametric analysis of Chi Squared (X2) and only the statistically significant results were reported. The level of statistical significance was of P < 0.05. Of 217 patients with NSCLC, 109 had brain metastases. 56.88% were male and the age averaged 59.49 ± 2.3 years, the age group between 45 and 65 years was significant (P=0,039). 72.47% of patients with brain metastases referred smoking habits. Adenocarcinoma was prevalent in 78.3%. Right mid-lobe primary, T3 and N2 disease at the time of diagnosis were significant (P= 0,0002). Nuclear grade 2 was more frequent (P=0,0000). Acinar pattern, presence of tumor emboli or lymphovascular invasion were more frequent in patients with brain metastases but not significant. Protein P63 was positive in 25.81% patients, especially in cases without brain metastases (P=0,00141). We recorded 9 EGFR mutations (8 in exon 19) and 7 had brain metastases (P = 0,0000). Also, 6 patients had ALK translocation detected, all with brain metastases (P=0,0248). Male gender, age between 45 and 65 at the time of diagnosis, ECOG 2, moderately differentiated adenocarcinoma, located in the right middle lobe, sized T3, or N2 nodes, stage IV with M1B metastasis, absence of P63, and mutations of EGFR or translocations of ALK, were more associated with the detection of brain metastases in patients with NSCLC. Other characteristics, like acinar pattern, presence of tumor emboli or lymphovascular invasion, expression of CK7, TTF1, and Napsin-A, were not significant but were frequently present in patients with brain metastases.