Epidemiology of Intracranial Metastases in Korea: A National Cohort Investigation.
OBJECTIVE
To investigate the epidemiologic features of intracranial metastases (ICMET) in Korea, we performed a cohort study using the National Health Insurance Service-National Sample Cohort database, which comprised healthcare usage information of approximately 1 million Korean individuals over 12 years.


METHODS
We enrolled 998,602 subjects, after excluding 18,218 subjects diagnosed with any cancer during the washout period (2002-2004). The observation period was 9 years (2005-2013; 8,725,438 person-years). The initial diagnosis date of ICMET and the primary cancer was recorded. The incidence was determined based on the number of incident cases and observation size, whereas survival was estimated using death statistics from the database.


RESULTS
Through observation period, a total 776 subjects developed ICMET. The age-standardized incidence of ICMET was 8.2 per 100,000 person-years. The mean interval between the initial diagnosis date of the primary cancer and ICMET was 13.1 months. Patients with ICMET had shorter survival than those without ICMET (30.9 months vs. 81.4 months, p < 0.001). The ICMET incidence among the cancer patients was 5.0 per 1,000 person-years; it was highest in lung cancer cases, followed by breast and liver cancer cases. Moreover, ICMET from lung cancer was the most common metastasis type, followed by ICMET from liver and breast cancer.


CONCLUSIONS
The incidence of ICMET was 8.2 per 100,000 person-years among the Korean population and 5.0 per 1,000 person-years among cancer patients. Most of the ICMET cases arose from lung cancer. ICMET also critically influenced survival in cancer patients.
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.|Seoul National University College of Medicine, Seoul, Korea.
Tackeun
T
Kim
Seoul National University College of Medicine, Seoul, Korea.|Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
Changhoon
C
Song
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.|Seoul National University College of Medicine, Seoul, Korea.
Jung Ho
JH
Han
Seoul National University College of Medicine, Seoul, Korea.|Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
In-Ah
IA
Kim
Seoul National University College of Medicine, Seoul, Korea.|Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Yu Jung
YJ
Kim
Seoul National University College of Medicine, Seoul, Korea.|Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Se Hyun
SH
Kim
Seoul National University College of Medicine, Seoul, Korea.|Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Jee Hyun
JH
Kim
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.|Seoul National University College of Medicine, Seoul, Korea.
Chae-Yong
CY
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000556:secondary*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult
Cohort; Epidemiology; Incidence; Intracranial metastases; Korea; National