Open AccessRisk of brain metastases in T1–3N0 NSCLC: a population-based analysis
Author(s) -
Michael T. Milano,
James E. Bates,
J. Budnik,
Haoming Qiu,
Sara Hardy,
Michael Cummings,
Megan Baumgart,
Ronald J. Maggiore,
Deborah Mulford,
Kenneth Usuki
Publication year - 2020
Publication title -
lung cancer management
Language(s) - English
Resource type - Journals
eISSN - 1758-1974
pISSN - 1758-1966
DOI - 10.2217/lmt-2019-0010
Subject(s) - medicine , lung cancer , oncology , incidence (geometry) , adenocarcinoma , epidemiology , stage (stratigraphy) , population , brain metastasis , cancer , metastasis , environmental health , biology , paleontology , physics , optics
Aim: Several consensus guidelines recommend against routine brain imaging at diagnosis of T1-3N0 non-small cell lung cancer (NSCLC). Methods: From the Surveillance, Epidemiology and End Results registry, patients with pathologically confirmed T1-3N0 NSCLC were identified. Risks of brain metastases at time of initial diagnosis were analyzed. Results: Patients selected to not undergo primary NSCLC resection had approximately tenfold greater incidence of brain metastases versus those who did. Younger age, adenocarcinoma histology, higher tumor stage and higher histologic grade were all significantly (p < 0.0001) associated with greater likelihood of presenting with brain metastases. Conclusion: Given the morbidity and mortality of brain metastases, routine brain screening after NSCLC diagnosis (particularly adenocarcinoma) may be justifiable, though more refined cost-benefit analyses are warranted.