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Cardiothoracic Surgery |

Efficacy of Surgical Treatment for Brain Metastasis in Patients With Non-small Cell Lung Cancer

Minkwang Byun, MS; Wou-Young Chung, MD
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Yonsei University College of Medicine, Seoul, Republic of Korea


Chest. 2014;145(3_MeetingAbstracts):59A. doi:10.1378/chest.1835240
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Abstract

SESSION TITLE: Thoracic Surgery

SESSION TYPE: Slide Presentations

PRESENTED ON: Saturday, March 22, 2014 at 09:00 AM - 10:00 AM

PURPOSE: Patients with non-small cell lung cancer (NSCLC) and synchronous brain metastases (BMs) on initial diagnosis, who presented with neurological deficits, had a short median survival and lower quality of life (QOL). We analyzed our experiences with surgical treatment of patients with NSCLC who had neurologically symptomatic, synchronous BMs.

METHODS: We performed a single-center, retrospective review of 36 patients who presented with synchronous BMs from NSCLC between April 2006 and December 2011. Patients were divided into three groups according to manifestation of neurological symptoms and the surgery received for BMs: asymptomatic patients (AS group; n = 14), symptomatic patients received neurosurgical resection (NSR group; n = 11) or non-neurosurgical resection (non-NSR group; n = 11). We analyzed overall survival (OS), intracranial progression-free survival (PFS), and quality of life.

RESULTS: In survival, there was no difference between patients with NSR (OS, 12.7 months) and non-NSR (OS, 10.4 months; p = 0.6419). Likewise for intracranial PFS, there was no significant survival difference (8.4 months in the NSR and 5.4 months in non-NSR group (p = 0.0624)). Reliable neurological 1-month follow-up by the Medical Research Council neurological function evaluation scale was available in 22 symptomatic patients. The scale improved in eight (73%) patients in the NSR group, but only in three (27%) in the non-NSR group.

CONCLUSIONS: Patients with synchronous BMs from NSCLC presenting with neurological symptoms showed no survival benefit from combined treatment with neurosurgical resection, but local BMs control and quality of life were improved.

CLINICAL IMPLICATIONS: we analyzed the outcomes of surgical treatment in patients with non-small cell lung cancer (NSCLC) who had neurologically symptomatic, synchronous brain metastasis. As a result, patients with synchronous brain metastasis from NSCLC presenting with neurological symptoms showed no survival benefit from combined treatment with neurosurgical resection, but local brain metastasis control and quality of life were improved.

DISCLOSURE: The following authors have nothing to disclose: Minkwang Byun, Wou-Young Chung

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