J Korean Med Sci.  2006 Apr;21(2):236-241. 10.3346/jkms.2006.21.2.236.

Surgical Treatment of Non-Small Cell Lung Cancer with Isolated Synchronous Brain Metastases

• I H
• Lee JI
• Nam DH
• Ahn YC
• Shim YM
• Kim K
• Choi YS
• Kim J

• KMID: 1781828
• DOI: http://doi.org/10.3346/jkms.2006.21.2.236

Abstract

This study is a retrospective examination of our experiences with patients who underwent treatment of isolated synchronous brain metastases coupled with primary non-small cell lung cancer. From January 1995 to June 2004, 12 patients presented with isolated synchronous brain metastases coupled with primary non-small cell lung cancer. The patient was comprised of 8 men and 4 women. The median age was 52 yr, in a range of 32 to 75 yr. Median follow-up duration was 10.6 months, in a range of 2 to 55.8 months. Recurrence developed in 7 patients, and the median interval from 1st treatment to recurrence was 4.5 months (2.8-6.5 months). The overall 1-yr survival rate was 61.7%. The 1-yr survival rates for pathologic N0 and N1 cases were 75% and 66.7%, respectively. The median survival duration for pathologic N2 was 6.2 months (95% CI, 4.8-7.5 months). The 1-yr survival rate for cases of single brain metastasis was 75%. Based on our current observations, we could speculate that aggressive management of primary non-small cell lung cancer and isolated synchronous brain metastases was beneficial in a selected group of patients, as long as the brain lesions and pulmonary lesions were limited or resectable.

Keyword

Carcinoma; Non-small Cell Lung; Craniotomy; Radiosurgery; Neoplasm Metastasis; Brain

MeSH Terms

Time Factors
Survival Rate
Retrospective Studies
Middle Aged
Male
Lung Neoplasms/mortality/*surgery
Humans
Female
Carcinoma, Non-Small-Cell Lung/mortality/*secondary/*surgery
Brain Neoplasms/mortality/*secondary/*surgery
Aged
Adult

Figure

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  Fig. 1 Overall survival.

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  Fig. 2 Survival according to locoregional pathologic N status.

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  Fig. 3 Preoperative chest CT and brain MRI of 54-yr-old man with locoregional pathologic stage T2N0 coupled with two metastatic brain lesions. A 5-cm sized central mass at the orifice of the right lower lobar bronchus protrudes into the right bronchus intermedius (A). Axial views of T2-weighted fluid-attenuated inversion recovery (FLAIR) imaging show a solid mass in the right cerebellar hemisphere (B), and in the medial portion of the left temporal lobe (C).

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