title: Significance of Primary Tumor Location and Histology for Brain Metastasis Development and Peritumoral Brain Edema in Lung Cancer.
abstract: BACKGROUND
  Brain metastasis of lung cancer adversely affects overall survival (OS) and quality of life, while peritumoral brain edema is responsible for life-threatening complications.
  
  
  METHODS
  We retrospectively analyzed the clinicopathological and cerebral radiological data of 575 consecutive lung cancer patients with brain metastases.
  
  
  RESULTS
  In adenocarcinoma and squamous cell carcinoma, peritumoral brain edema was more pronounced than in small-cell lung cancer (p < 0.001 and p < 0.001, respectively). There was a positive correlation between the size of metastasis and the thickness of peritumoral brain edema (p < 0.001). It was thicker in supratentorial tumors (p = 0.019), in younger patients (≤50 years) (p = 0.042), and in females (p = 0.016). The time to development of brain metastasis was shorter in central than in peripheral lung cancer (5.3 vs. 9.0 months, p = 0.035). Early brain metastasis was characteristic for adenocarcinomas. A total of 135 patients had brain only metastases (N0 disease) characterized by peripheral lung cancer predominance (p < 0.001) and a longer time to development of brain metastasis (9.2 vs. 4.4 months, p < 0.001). OS was longer in the brain only subgroup than in patients with N1-3 diseases (p < 0.001).
  
  
  CONCLUSIONS
  The clinicopathological characteristics of lung cancer are related to the development and radiographic features of brain metastases. Our results might be helpful in selecting patients who might benefit from prophylactic cranial irradiation.
authors: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors: Katalin
authors: K
authors: Fábián
authors: Márton
authors: M
authors: Gyulai
authors: József
authors: J
authors: Furák
authors: Péter
authors: P
authors: Várallyay
authors: Márta
authors: M
authors: Jäckel
authors: Krisztina
authors: K
authors: Bogos
authors: Balázs
authors: B
authors: Döme
authors: Judit
authors: J
authors: Pápay
authors: József
authors: J
authors: Tímár
authors: Zoltán
authors: Z
authors: Szállási
authors: Judit
authors: J
authors: Moldvay
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D001929:Brain Edema / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D005260:Female; D006801:Humans; D015192:Infratentorial Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D015996:Survival Rate; D013997:Time Factors; D047368:Tumor Burden