| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2001;20:361-366
© 2001 Elsevier Science NL
General Thoracic Surgery, Department of General Surgery, "A. Gemelli" Hospital-Catholic University of Rome, Rome, Italy
Received 9 October 2000; received in revised form 26 March 2001; accepted 4 April 2001.
Corresponding author. Tel.: +39-0328-5446282; fax: +39-06-3051162
e-mail: antodan{at}tiscalinet.it
Objective: The prognosis of non-small cell lung cancer (NSCLC) with brain metastasis is very poor, with median survival rate below 6 months, even if treated with palliative radio and/or chemotherapy. To assess the effectiveness of surgical treatment for this kind of patients we reviewed our experience. Methods: From January 1989 to October 1999, 30 patients (26 males and four females; mean age: 58.7 years) with NSCLC and single brain metastasis underwent surgical treatment of both primary lung cancer and secondary cerebral lesion. Patients (pts) were divided into two major groups. In group 1 (G1) 20 pts (18 males and two females) presented a synchronous brain metastasis. In group 2 (G2) 10 pts (eight males and two females) presented a metachronous brain metastasis during the follow-up period (range 3–24 months since the primary tumor). Patients selected in G1 had T1–2, N0–1 clinical staging, good ‘performance status’ (ECOG:0–1; Karnofsky index >70%), age<75 years. Craniotomy has always been the first approach. In G2 also patients with locally advanced tumors (T3 and/or N2) were included. Whole brain radiotherapy and/or chemotherapy was the post-operative choice treatment. Results: Histologic findings have shown: adenocarcinoma in 17 cases (12 in G1; five in G2), squamous cell carcinoma in 10 cases (six in G1; four in G2), large cell carcinoma in 2 (one in G1; one in G2) and large cell neuroendocrine carcinoma in one (G1). Survival analysis (Kaplan–Meier method) has shown an overall value of 80% at 1 year (95% in G1; 50% in G2), 41% at 2 years (47% in G1; 30% in G2) and 17% at 3 years (14% in G1; 20% in G2). Overall median survival is 23 months (23 in G1; 11 in G2); mean survival 27.8 months (30.3 months in G1; 22.8 months in G2). According to univariate analysis prognosis is definitively better in N0 tumors compared to N1–2 tumors and in adenocarcinoma cases compared to other histotypes (P<0.05). Conclusions: We can conclude that combined surgical therapy is, nowadays, the choice treatment for this kind of patients, even though restricted to selected cases. The knowledge of prognostic factors may optimize indications for surgery.
Key Words: Lung cancer • Brain metastasis • Surgical treatment
This article has been cited by other articles:
|
|
 |
|
  T. Hishida, K. Nagai, J. Yoshida, M. Nishimura, G.-i. Ishii, M. Iwasaki, and Y. Nishiwaki Is surgical resection indicated for a solitary non-small cell lung cancer recurrence? J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 838 - 842. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Getman, E. Devyatko, D. Dunkler, F. Eckersberger, A. End, W. Klepetko, G. Marta, and M. R. Mueller Prognosis of patients with non-small cell lung cancer with isolated brain metastases undergoing combined surgical treatment Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 1107 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Danesi, F. De Braud, S. Fogli, T. M. De Pas, A. Di Paolo, G. Curigliano, and M. Del Tacca Pharmacogenetics of Anticancer Drug Sensitivity in Non-Small Cell Lung Cancer Pharmacol. Rev., March 1, 2003; 55(1): 57 - 103. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
