Prognosis of patients with non-small cell lung cancer with isolated brain metastases undergoing combined surgical treatment

Getman, Vladyslav; Devyatko, Elena; Dunkler, Daniela; Eckersberger, Franz; End, Adelheid; Klepetko, Walter; Marta, Gabriel; Mueller, Michael Rolf
June 2004
European Journal of Cardio-Thoracic Surgery;Jun2004, Vol. 25 Issue 6, p1107
Academic Journal
Objective: To compare survival of patients with isolated synchronous and metachronous brain metastases from non-small cell lung cancer (NSCLC) after combined surgical treatment. Methods: A total of 991 patients underwent surgical resection of primary NSCLC between January 1994 and November 1999. Out of these, 32 patients (21 males and 11 females) were further treated for isolated brain metastases. In a retrospective survey, the outcome of patients with either synchronous (group 1, n=16) or metachronous (group 2, n=16) brain metastases was evaluated. Five patients out of each group received either adjuvant or neo-adjuvant chemotherapy. Data analysis includes descriptive statistics, Wilcoxon test, Kaplan–Meier method and Cox''s proportional hazards model. Results: There was no significant difference in local tumour stage and histology of the primary tumour between both groups. Median of the disease free interval (DFI) after primary lung surgery (group 2) was 10 months, range 3–60 months. Median survival after lung surgery was 8.5 months in group 1 and 16.4 months in group 2 (P=0.094). Median survival after cerebral procedures was 9.3 and 6.2 months, respectively (P=0.127). Estimated survival rates by Kaplan–Meier method after cerebral procedures operation in group 1 were 37.5% at 1 year, 25.0% at 2 years and 18.8% at 5 years; in group 2 estimated survival rates were 31.3% at 1 year, 15.6% at 2 years and 0% at 5 years (P=0.148). Calculated survival rates after lung surgery were identical in group 1; in group 2 survival rates were 62.5, 43.8 and 18.8% at 1, 2 and 5 years, respectively (P=0.101). In the univariate model, none of the following variables had effect on survival: sex, age, T stage of the tumour, nodal status, timing of metastatic lesions, number of cerebral metastases, complete resection of primary tumour and histological type. Multivariate analysis did not reveal any risk factor, which significantly predicted survival. DFI did not correlate with survival of patients in group 2. Conclusions: Once isolated synchronous or metachronous brain metastases from NSCLC have developed, there is no difference in prognosis after combined surgery between analysed groups. This questions the value of lung resection in patients with isolated synchronous brain metastases.


Related Articles

  • Docetaxel and carboplatin combination chemotherapy for recurrent endometrial cancer. Obata, Hiroaki; Aoki, Yoichi; Watanabe, Minoru; Matsushita, Hiroshi; Yahata, Tetsuro; Fujita, Kazuyuki; Kurata, Hitoshi; Tanaka, Kenichi // International Journal of Clinical Oncology;Feb2003, Vol. 8 Issue 1, p53 

    There is no consensus regarding the optimal chemotherapy for endometrial cancer patients, and a need for better chemotherapy is evident. Two individuals with recurrent metastatic endometrial cancer treated with docetaxel and carboplatin combination chemotherapy are presented here. Both cases...

  • History of Cancer, Ancient and Modern Treatment Methods. Sudhakar, Akulapalli // Journal of Cancer Science & Therapy;Dec2009, Vol. 1 Issue 2, p1 

    The author reflects on the history of cancer and its ancient and modern treatment methods in the U.S. He mentions an overview of cancer as the second leading cause of death worldwide after cardiovascular diseases where half of men and one third of women develop cancer and millions of cancer...

  • How important is the opinion of significant others to cancer patients’ adjuvant chemotherapy decision-making? A. Stiggelbout; S. Jansen; W. Otten; M. Baas-Thijssen; H. van Slooten; C. van de Velde // Supportive Care in Cancer;Mar2007, Vol. 15 Issue 3, p319 

    AbstractGoals??Decisions regarding adjuvant chemotherapy are difficult, since value tradeoffs are involved. Little is known about the importance of the significant others in patients? decision-making regarding adjuvant treatment. We surveyed patients with breast and colorectal cancer about the...

  • Influence of Timing of Initiation of Adjuvant Chemotherapy Over Survival in Breast Cancer: A Negative Outcome Study by the Spanish Breast Cancer Research Group (GEICAM). Carlos Jara Sánchez; Amparo Ruiz; Miguel Martín; Antonio Antón; Blanca Munárriz; Arrate Plazaola; José Schneider; Purificación del Prado; Emilio Alba; Antonio Fernández-Aramburo // Breast Cancer Research & Treatment;Jan2007, Vol. 101 Issue 2, p215 

    AbstractPurpose??This retrospective trial evaluates whether the timing of initiation of the adjuvant chemotherapy has any influence over survival in early-stage breast cancer.Patients and methods??A total of 2782 patients from El ?lamo project (from 1990 to 1997;n?=?15,400) were selected with...

  • Free or low-cost cleaning for cancer patients.  // Long Island Business News (7/1993 to 5/2009);8/22/2008, Vol. 55 Issue 41, p26A 

    The article reports on the free or low-cost cleaning services offer of Teresa's Family Cleaning (TFC) in Long Island, New York. Report says, women who are having chemotherapy treatments for cancer in the area are the beneficiaries of the said offer. Meanwhile, aside from the said offer, TFC is...

  • INTEGRATING ACUPUNCTURE SERVICES INTO AN INFUSION CLINIC.  // Journal of the Society for Integrative Oncology;Fall2007, Vol. 5 Issue 4, p173 

    The Massachusetts General Hospital Cancer Center's HOPES Program initiated a pilot project in the spring of 2006, which offers acupuncture services to patients during their chemotherapy infusion treatments. While patients receive infusion treatment, acupuncture points in the ear are used to...

  • Gefitinib in elderly and unfit patients affected by advanced non-small-cell lung cancer. Gridelli, C.; Maione, P.; Castaldo, V.; Rossi, A. // British Journal of Cancer;11/17/2003, Vol. 89 Issue 10, p1827 

    Elderly and poor performance status advanced non-small-cell lung cancer (NSCLC) patients often tolerate chemotherapy poorly. Special approaches are needed for these patient populations. Gefitinib (Iressa) was used in 59 elderly and/or unfit NSCLC pretreated patients participating in a...

  • Life goals and purpose in life in cancer patients. Martin Pinquart; Rainer Silbereisen; Cornelia Fröhlich // Supportive Care in Cancer;Mar2009, Vol. 17 Issue 3, p253 

    Abstract Goal of work  The purpose of the study was to analyze associations between life goals and purpose in life in cancer patients. Patients and methods  A sample of 153 cancer patients was assessed before the start of chemotherapy and about 9 months later. Purpose in life...

  • Evaluation of the relative importance of chemotherapeutic and antiemetic efficacy in various oncologic settings. David Ettinger; Steven Grunberg; A. Hauber; Ateesha Mohamed // Supportive Care in Cancer;Apr2009, Vol. 17 Issue 4, p405 

    Abstract Goals of work  This study investigated physician’s attitudes toward the relative importance of chemotherapeutic and antiemetic efficacy in different clinical scenarios. Materials and methods  Oncologists in the USA and four European countries completed an online...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics