Lung cancer and its operable brain metastasis: survival rate and staging problems.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Furák
József
J
Departments of Medical Informatics, Pathology, and Surgery, University of Szeged, Szeged. jfurak@hotmail.com
Troján
Imre
I
Szöke
Tamás
T
Agócs
László
L
Csekeö
Attila
A
Kas
József
J
Svastics
Egon
E
Eller
József
J
Tiszlavicz
László
L
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003399:Craniotomy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015993:Life Tables; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging / Q000379:methods*; D011013:Pneumonectomy; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D013120:Spinal Cord Neoplasms / Q000556:secondary / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate