P2.03b-004 Factors Associated with Brain Metastasis in Patients with Lung Adenocarcinoma after Surgical Resection: Topic: Brain Meta

Abstract

The aim of the study is to demonstrate the relationship between clinicopathological variables and brain metastasis in patients with resected lung adenocarcinoma. The clinicopathological characteristics of 748 patients of resected lung adenocarcinoma at Taipei Veterans General Hospital between 2004 and 2012 were retrospectively reviewed. Comprehensive histological subtyping was performed according to the percentage of each invasive histologic component. The prognostic value of clinicopathological variables for brain metastasis-free survival was demonstrated. Among the 182 patients with distant metastasis, 93 (51.1%) patients developed contralateral lung metastasis, 81 (44.5%) had brain metastasis, 71 (39.0%) had bone metastasis, and 18 (8.9%) had liver metastasis during follow-up. Greater tumor size (Hazard ratio [HR], 1.276; 95% confidence interval [CI], 1.045 to 1.559; P = 0.017), stage II or III (vs. stage I) (HR, 2.469; 95% CI, 1.201 to 5.076; P = 0.014), angiolymphatic invasion (HR, 1.818; 95% CI, 1.037 to 3.189; P = 0.037), and micropapillary predominant (HR, 2.686; 95% CI, 1.270 to 5.683; P = 0.010) were significantly associated with more brain metastasis in multivariate analysis. Angiolymphatic invasion (HR, 2.632; 95% CI, 1.420 to 4.879; P = 0.002) and micropapillary predominant (HR, 2.186; 95% CI, 1.148 to 4.163; P = 0.017) were significant prognostic factors for worse brain metastasis-free survival in multivariate analysis. Angiolymphatic invasion and micropapillary predominant pattern are significantly associated with brain metastasis in patients with resected lung adenocarcinoma. This information is important for patient follow-up strategy and further study of the mechanisms leading to brain metastasis.