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Results and prognostic factors of surgery in the management of non‐small cell lung cancer with solitary brain metastasis
Author(s) -
Macchiarini Paolo,
Mussi Alfredo,
Angeletti Carlo A.,
Buonaguidi Renato,
Hardin Michael
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910715)68:2<300::aid-cncr2820680215>3.0.co;2-s
Subject(s) - medicine , lung cancer , brain metastasis , univariate analysis , lymph node , primary tumor , chemotherapy , thorax (insect anatomy) , metastasis , surgery , histology , proportional hazards model , cancer , oncology , multivariate analysis , anatomy
Between 1975 and 1988, 37 patients with resectable non‐small cell lung cancer (NSCLC) and synchronous (within 1 month, n = 10) or metachronous (n = 27) solitary brain metastasis (SBM) underwent combined excision of their lesions. Overall 5‐year and median survival were 30% and 27 months (range, 3 to 125+ months), respectively. Twenty‐seven patients had a relapse, and their median disease‐free interval (DFI) was 17.5 months (range, 1 to 108 months). The most frequent (78%, n = 20) site of first recurrence locally was either the ipsilateral thorax (n = 14) or brain (n = 6). In univariate analysis, age, primary tumor and lymph node status; tumor histology, size, and side; type of pulmonary resection; side and location of SBM; and onset of presentation did not affect survival and DFI. By contrast, the interval (≦ versus > 12 months) between the two operations significantly affected survival ( P = 0.0096) and DFI ( P = 0.046). The DFI was also affected by the administration of adjuvant chemotherapy (AC) for the primary tumor ( P = 0.02). Using the Cox model, AC was the most independent predictor of DFI. These data support the inclusion of surgery in the therapeutic armamentarium for patients with NSCLC and SBM.