Lung Cancer and Its Operable Brain Metastasis: Survival Rate and Staging Problems

• Published in: The Annals of thoracic surgery Vol. 79; no. 1; pp. 241 - 247
• Main Authors: Furák, József, Troján, Imre, Szöke, Tamás, Agócs, László, Csekeö, Attila, Kas, József, Svastics, Egon, Eller, József, Tiszlavicz, László
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 2005
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - radiotherapy; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Brain Neoplasms - mortality; Brain Neoplasms - radiotherapy; Brain Neoplasms - secondary; Brain Neoplasms - surgery; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - surgery; Combined Modality Therapy; Cranial Irradiation; Craniotomy; Disease-Free Survival; Female; Humans; Hungary - epidemiology; Life Tables; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging - methods; Pneumonectomy; Radiotherapy, Adjuvant; Reoperation; Spinal Cord Neoplasms - secondary; Spinal Cord Neoplasms - surgery; Survival Analysis; Survival Rate; Hungary; 10
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2004.06.051

We assessed the survival rates regarding different stages of operable lung cancers causing operable brain metastasis in patients with or without cancer-related symptoms. The correlation between survival rates and the disease-free interval between lung surgery and metastasectomy was studied.
Sixty-five patients were operated on for lung cancer and brain metastases. The disease-free interval was divided into 5 subgroups: 0–2 months, 3–5 months, 6–11 months, 12–23 months, and 24 months and beyond. The study group comprised of patients with lung cancer in the following stages: 17 patients in stage I (1 patient in stage IA, 16 patients in stage IB), 16 patients in stage II (2 patients in stage IIA, 14 patients in stage IIB), 9 patients in stage IIIA, 4 patients in stage IIIB, and 19 patients in stage IV. Forty-four patients were symptom-free for lung cancer and 21 patients manifested lung cancer related symptoms.
The 5-year survival rates were as follows: stage I = 22%, stage II = 20%, stage IIIA = 22%, stage IIIB = 0%, and stage IV = 23% after lung resections. There were no significant differences in the 5-year survival rates regarding the disease-free interval subgroups after brain metastasectomies (
p = 0.19): disease-free interval 0–2 months = 22% and disease-free interval 24 months and beyond = 23%. The 5-year survival rate after metastasectomy was significantly greater (26% vs 5%) in patients without lung cancer related symptoms (
p = 0.05).
The 5-year survival rate in stage I, II, IIIA, and IV lung cancer with operable hematogenous brain metastases corresponds to that in the customary stage IIIA (23%). The disease-free interval exhibited no significant impact on the survival rate. The complaint-free status exhibits a significantly greater impact on the survival rate in hematogenic metastasis.