Prognostic factors in patients with postoperative brain recurrence from completely resected non-small cell lung cancer.
BACKGROUND
Treatment strategies for brain metastasis from lung cancer have been making progress. The aim of this retrospective analysis was to investigate the post-recurrent prognostic factors in patients with brain metastasis after complete resection of non-small cell lung cancer (NSCLC).


METHODS
We retrospectively reviewed the medical records of 40 patients found to have postoperative brain metastasis from NSCLC in our institution from 2002 to 2008. All patients had undergone radical pulmonary resection for the lung cancer. The impact of numerous variables on survival were assessed, including gender, age, carcinoembryonic antigen (CEA), tumor size, N status, histological type, number of brain metastases, tumor size of brain metastasis, presence of symptoms from the brain tumor(s), and use of perioperative chemotherapy.


RESULTS
The median follow-up was 20.6 months (range, 3.4-66 months). The five-year survival rate from the diagnosis of brain recurrence was 22.5%. In univariate analysis, the favorable prognostic factors after brain recurrence included a normal range of CEA, no extracranial metastasis, no symptoms from the brain metastasis, brain metastasis (less than 2 cm), and radical treatment (craniotomy or stereotactic radiosurgery [SRS]). The multivariate Cox model identified that a small brain metastasis and radical treatment were independent favorable prognostic factors.


CONCLUSIONS
This study found that the implementation of radical therapy for metastatic brain tumor(s) when the tumor is still small contributed to an increase in patients' life expectancy.
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Takashi
T
Kanou
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Jiro
J
Okami
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Toshiteru
T
Tokunaga
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Daisuke
D
Ishida
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Hidenori
H
Kuno
Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka, Japan.
Masahiko
M
Higashiyama
Brain metastasis; lung cancer; postoperative recurrence; prognostic factors