title: A diagnostic model to detect silent brain metastases in patients with non-small cell lung cancer.
abstract: We aimed to discriminate subgroups according to the risk of brain metastases in patients with non-small cell lung cancer (NSCLC) lacking neurological symptoms. We performed a retrospective review of 433 patients with NSCLC who underwent chest computed tomography (CT), brain magnetic resonance imaging (MRI) and bone scans at an initial staging work-up between April 2003 and April 2007. Brain metastases were determined by MRI. Patients were stratified into groups according to the number of risk factors (0-3) identified by multivariate analysis. In multivariate analysis, histopathology with non-squamous cell carcinoma, nodal stage 2 on CT and presence of bone metastases were three risk factors for brain metastases. Patients were divided into four groups according to the number (0-3) of these predictive factors. The proportions of patients with brain metastases in the four groups were 2%, 3%, 17% and 35%, respectively, and these differences were significant (P<0.001). When analysis was performed in patients with localised disease, the number of risk factors was correlated with the prevalence of brain metastases (P=0.013) but stage was not (P=0.153). Although this diagnostic model should be validated through further studies, our data suggest that the number of risk factors might be a useful tool to identify silent brain metastases in patients with NSCLC.
authors: Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-Gu, Seoul, Republic of Korea. hmona@kcch.re.kr
authors: Im Il
authors: II
authors: Na
authors: Tae Hyun
authors: TH
authors: Lee
authors: Du Hwan
authors: DH
authors: Choe
authors: Gi Jeong
authors: GJ
authors: Cheon
authors: Cheol Hyeon
authors: CH
authors: Kim
authors: Jae Soo
authors: JS
authors: Koh
authors: Heejong
authors: H
authors: Baek
authors: Baek-Yeol
authors: BY
authors: Ryoo
authors: Sung Hyun
authors: SH
authors: Yang
authors: Jae Cheol
authors: JC
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed