The Surgical Management of Brain Metastases in Non-Small Cell Lung Cancer (NSCLC): Identification of the Early Laboratory and Clinical Determinants of Survival.

Matthias Schneider,Jennifer Landsberg,Johannes Weller,Lars Eichhorn,Christian Bode,Ulrich Herrlinger,Alexander Radbruch,Yon-Dschun Ko,Erdem Güresir,Christina Schaub,Frank A Giordano,Katjana S Schwab,Niklas Schäfer,Patrick Schuss,Hartmut Vatter,Felix Lehmann,Muriel Heimann

doi:10.3390/jcm10174013

Matthias Schneider, Jennifer Landsberg + Show 15 more

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https://doi.org/10.3390/jcm10174013

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Abstract

Background: Brain metastases (BM) indicate advanced states of cancer disease and cranial surgery represents a common treatment modality. In the present study, we aimed to identify the risk factors for a reduced survival in patients receiving a surgical treatment of BM derived from non-small cell lung cancer (NSCLC). Methods: A total of 154 patients with NSCLC that had been surgically treated for BM at the authors’ institution between 2013 and 2018 were included for a further analysis. A multivariate analysis was performed to identify the predictors of a poor overall survival (OS). Results: The median overall survival (mOS) was 11 months (95% CI 8.2–13.8). An age > 65 years, the infratentorial location of BM, elevated preoperative C-reactive protein levels, a perioperative red blood cell transfusion, postoperative prolonged mechanical ventilation (>48 h) and the occurrence of postoperative adverse events were identified as independent factors of a poor OS. Conclusions: The present study identified several predictors for a worsened OS in patients that underwent surgery for BM of NSCLC. These findings might guide a better risk/benefit assessment in the course of metastatic NSCLC therapy and might help to more sufficiently cope with the challenges of cancer therapy in these advanced stages of disease.

Highlights

Introduction conditions of the Creative CommonsThe diagnosis of brain metastases (BM) is associated with a rather poor prognosis, indicating an uncontrolled primary disease that has spread to the otherwise relatively unattainable central nervous system [1]
The records of patients with Brain metastases (BM) originating from non-small cell lung cancer (NSCLC) who had undergone surgical treatment at the authors’ facility between 2013 and 2018 were screened and relevant data were extracted into a database (SPSS, version 25, IBM Corp., Armonk, NY, USA)
154 patients with NSCLC and a surgically treated BM were included in a further analysis

Summary

Introduction

The diagnosis of brain metastases (BM) is associated with a rather poor prognosis, indicating an uncontrolled primary disease that has spread to the otherwise relatively unattainable central nervous system [1]. The diagnosis of BM was considered to be an event indicating the terminal stage of an apparently uncontrollable underlying disease and further treatment options were considered to be limited [1,3,4]. Brain metastases (BM) indicate advanced states of cancer disease and cranial surgery represents a common treatment modality. We aimed to identify the risk factors for a reduced survival in patients receiving a surgical treatment of BM derived from non-small cell lung cancer (NSCLC). Methods: A total of 154 patients with NSCLC that had been surgically treated for BM at the authors’ institution between 2013 and 2018 were included for a further analysis.

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