title: The outcome of bifocal surgical resection in non-small cell lung cancer with synchronous brain metastases: results of a single center retrospective study.
abstract: BACKGROUND
  The reported median survival in patients with non-small cell lung cancer (NSCLC) metastases to the brain varies from 3 to 12 months with combined treatment modalities. Bifocal surgical resection of synchronous brain metastasis and primary NSCLC has not been reported widely, and there have been only a small number of articles published in the literature. The aim of this retrospective study was to evaluate the prognostic factors among patients undergoing bifocal surgical resection.
  
  
  METHODS
  We retrospectively analyzed 28 patients who had a solitary metastatic brain lesion at the time of diagnosis, and underwent synchronous surgical resection of the brain metastasis and primary lung tumor. Survival time was measured in all the patients from the date of craniotomy until death or the most recent date of follow-up for those still surviving.
  
  
  RESULTS
  Mean age was 53 years. The mean length of follow-up was 23.6 (4-69) months. The overall survival rates were 79, 42, and 8% at the 1st, 2nd, and 5th years, respectively. The median length of survival was 24 ± 3.8 months. The median survival was found to be statistically significantly lower for the stage T3 tumors when compared with both stage T1 and T2 tumors (p = 0.037).
  
  
  CONCLUSIONS
  NSCLC patients with resectable solitary cranial metastasis, low locoregional stage (stages IA, IB, IIA) in which T3 status is counted out, with no mediastinal lymph node involvement or any other extrathoracic spread will mostly benefit from consecutive complete resection of both tumors and are supposed to have a better survival.
authors: Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Cabir
authors: C
authors: Yuksel
authors: Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Melih
authors: M
authors: Bozkurt
authors: Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Bulent Mustafa
authors: BM
authors: Yenigun
authors: Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Serkan
authors: S
authors: Enon
authors: Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Murat
authors: M
authors: Ozkan
authors: Department of Biostatistic, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: S Kenan
authors: SK
authors: Kose
authors: Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: Ayten Kayı
authors: AK
authors: Cangir
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019635:Neurosurgical Procedures / Q000379:methods*; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology