title: Brain metastases in malignant pleural mesothelioma.
abstract: The brain is a rare site of metastasis in malignant pleural mesothelioma (MPM), and its clinical features and prognosis remain unclear. The aim of this study was to investigate the incidence, prognosis, and risk factors for brain metastases (BM) in MPM patients. Between July 1993 and October 2014, 150 patients with histologically proven MPM were included in this retrospective study. The cumulative incidence of BM was estimated with the Kaplan-Meier method, and differences between groups were analyzed by the log-rank test. Multivariate logistic regression analysis was applied to assess risk factors for BM. The median follow-up time was 11 months (range 0-154.0 months). A total of eight patients (5.3 %) developed BM during the course of their illness. Multivariate analysis identified age <65 years (odds ratio [OR] = 5.83, p = 0.038) and International Mesothelioma Interest Group stage IV (OR = 1.69, p = 0.040) as independent factors related to increased risk of developing BM. The 1-and 2-year cumulative rates of BM were 4.0 % (95 % confidence intervals [CI] 1.4-8.5 %) and 5.3 % (95 % CI 2.3-10.2 %), respectively. Our study showed that the overall survival (OS) of patients with BM was worse than that of patients without BM (median OS 6.5 vs. 11.0 months, p = 0.037). The prognosis for BM in MPM patients is poor. Clinicians should perform careful screening for BM, especially in patients with risk factors.
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamagishi
authors.affiliation: Department of Medical Oncology, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minamiku, Okayama, 702-8055, Japan. nobufujimot@gmail.com.
authors.forename: Nobukazu
authors.identifier: http://orcid.org/0000-0002-4516-0433
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Asano
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fuchimoto
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Sae
authors.initials: S
authors.lastname: Wada
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ozaki
authors.affiliation: Department of Surgery, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishi
authors.affiliation: Department of Internal Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kishimoto
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary*; D008297:Male; D008654:Mesothelioma / Q000401:mortality / Q000556:secondary*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Asbestos; Brain; Brain metastases; Central nervous system; Malignant pleural mesothelioma