Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments
Objective: We attempted to analyze whether early presentation with brain metastases (BM) represents a poor prognostic factor in patients with non-small cell lung cancer (NSCLC), which should guide the treatment team towards less intensified therapy. Patients and methods: In a retrospective bi-centri...
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MDPI AG
2020-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/12/3618 |
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| author | Stephanie T. Jünger Petra Schödel Daniel Ruess Maximilian Ruge Julia-Sarita Brand Maike Wittersheim Marie-Lisa Eich Nils-Ole Schmidt Roland Goldbrunner Stefan Grau Martin Proescholdt |
| author_facet | Stephanie T. Jünger Petra Schödel Daniel Ruess Maximilian Ruge Julia-Sarita Brand Maike Wittersheim Marie-Lisa Eich Nils-Ole Schmidt Roland Goldbrunner Stefan Grau Martin Proescholdt |
| author_sort | Stephanie T. Jünger |
| collection | DOAJ |
| description | Objective: We attempted to analyze whether early presentation with brain metastases (BM) represents a poor prognostic factor in patients with non-small cell lung cancer (NSCLC), which should guide the treatment team towards less intensified therapy. Patients and methods: In a retrospective bi-centric analysis, we identified patients receiving surgical treatment for NSCLC BM. We collected demographic-, tumor-, and treatment-related parameters and analyzed their influence on further survival. Results: We included 377 patients. Development of BM was precocious in 99 (26.3%), synchronous in 152 (40.3%), and metachronous in 126 (33.4%) patients. The groups were comparable in terms of age (<i>p</i> = 0.76) and number of metastases (<i>p</i> = 0.11), and histology (<i>p</i> = 0.1); however, mutational status significantly differed (<i>p</i> = 0.002). The precocious group showed the worst clinical status as assessed by Karnofsky performance score (KPS) upon presentation (<i>p</i> < 0.0001). Resection followed by postoperative radiotherapy was the predominant treatment modality for precocious BM, while in syn- and metachronous BM surgical and radio-surgical treatment was balanced. Overall survival (OS) did not differ between the groups (<i>p</i> = 0.76). A good postoperative clinical status (KPS ≥ 70) and the application of any kind of adjuvant systemic therapy were independent predictive factors for OS. Conclusion: Early BM presentation was not associated with worse OS in NSCLC BM patients. |
| first_indexed | 2024-03-10T14:21:49Z |
| format | Article |
| id | doaj.art-d5d4ade4137a43b289d3e42278b5c7ba |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T14:21:49Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d5d4ade4137a43b289d3e42278b5c7ba2023-11-20T23:20:59ZengMDPI AGCancers2072-66942020-12-011212361810.3390/cancers12123618Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular TreatmentsStephanie T. Jünger0Petra Schödel1Daniel Ruess2Maximilian Ruge3Julia-Sarita Brand4Maike Wittersheim5Marie-Lisa Eich6Nils-Ole Schmidt7Roland Goldbrunner8Stefan Grau9Martin Proescholdt10Centre for Neurosurgery, Department of Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyDepartment of Neurosurgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyCentre for Integrated Oncology, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyCentre for Integrated Oncology, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyCentre for Neurosurgery, Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyDepartment of Pathology, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyDepartment of Pathology, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyDepartment of Neurosurgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyCentre for Neurosurgery, Department of Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyCentre for Neurosurgery, Department of Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, 50931 Cologne, GermanyDepartment of Neurosurgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyObjective: We attempted to analyze whether early presentation with brain metastases (BM) represents a poor prognostic factor in patients with non-small cell lung cancer (NSCLC), which should guide the treatment team towards less intensified therapy. Patients and methods: In a retrospective bi-centric analysis, we identified patients receiving surgical treatment for NSCLC BM. We collected demographic-, tumor-, and treatment-related parameters and analyzed their influence on further survival. Results: We included 377 patients. Development of BM was precocious in 99 (26.3%), synchronous in 152 (40.3%), and metachronous in 126 (33.4%) patients. The groups were comparable in terms of age (<i>p</i> = 0.76) and number of metastases (<i>p</i> = 0.11), and histology (<i>p</i> = 0.1); however, mutational status significantly differed (<i>p</i> = 0.002). The precocious group showed the worst clinical status as assessed by Karnofsky performance score (KPS) upon presentation (<i>p</i> < 0.0001). Resection followed by postoperative radiotherapy was the predominant treatment modality for precocious BM, while in syn- and metachronous BM surgical and radio-surgical treatment was balanced. Overall survival (OS) did not differ between the groups (<i>p</i> = 0.76). A good postoperative clinical status (KPS ≥ 70) and the application of any kind of adjuvant systemic therapy were independent predictive factors for OS. Conclusion: Early BM presentation was not associated with worse OS in NSCLC BM patients.https://www.mdpi.com/2072-6694/12/12/3618brain metastasisradiosurgeryneurosurgeryprecocioussynchronousmetachronous |
| spellingShingle | Stephanie T. Jünger Petra Schödel Daniel Ruess Maximilian Ruge Julia-Sarita Brand Maike Wittersheim Marie-Lisa Eich Nils-Ole Schmidt Roland Goldbrunner Stefan Grau Martin Proescholdt Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments Cancers brain metastasis radiosurgery neurosurgery precocious synchronous metachronous |
| title | Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments |
| title_full | Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments |
| title_fullStr | Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments |
| title_full_unstemmed | Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments |
| title_short | Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments |
| title_sort | timing of development of symptomatic brain metastases from non small cell lung cancer impact on symptoms treatment and survival in the era of molecular treatments |
| topic | brain metastasis radiosurgery neurosurgery precocious synchronous metachronous |
| url | https://www.mdpi.com/2072-6694/12/12/3618 |
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