Background
Brain metastases (BM) remain an important cause of morbidity and mortality in lung cancer patients. Our study evaluated population-based incidence and outcomes of BM in patients with non-metastatic lung cancer.
Methods
Patients diagnosed with non-metastatic first primary lung cancer, between 1973–2011, in the Metropolitan Detroit Surveillance Epidemiology and End Results (SEER) registry were used for analysis. Age-adjusted Odds Ratios (OR) of developing BM based on various demographic characteristics and histology were calculated with 95% confidence intervals (CIs). Adjusted Cox Proportional Hazards Ratios and Log Rank Tests of Kaplan-Meier Survival Curves were calculated to evaluate survival differences for non-small cell (NSCLC) and small cell lung cancers (SCLC).
Results
The incidence of BM in non-metastatic NSCLC and SCLC was 9% and 18% respectively. There was variation in the incidence of BM according to NCSLC histology. Incidence of BM was higher in patients < 60 years old in both NSCLC and SCLC, but there were no differences by race for either histological group. Female patients with NSCLC were more likely to have BM than males. There was variation in proportion of BM in both NSCLC and SCLC patients over the three 13-year of diagnosis periods. Risk of death (hazard ratio, HR) was significantly higher for those with BM in NSCLCs, but not significantly higher in SCLC.
Conclusions
The incidence of BM in non-metastatic lung cancer patients varies according to histology, age, and sex. BM are associated with worse survival for NSCLC but not SCLC.
Eosinophilic esophagitis (EoE) is a clinicopathologic disorder, characterized by esophageal symptoms (typically dysphagia) and mucosal eosinophilia. The chronic inflammation of EoE is thought to result in progressive, fibrostenotic remodeling of the esophageal wall, observed endoscopically by the characteristic findings of a ringed esophagus, focal strictures, and narrow caliber esophagus. 1,2 High-resolution functional lumen imaging probe (FLIP) utilizes impedance planimetry to measure adjacent cross-sectional areas (CSA) within a cylindrical bag placed in the esophagus. Stepwise intra-bag volume distension progressively opens the esophageal lumen until a distension plateau (DP) is reached, at which point further increase in intra-bag pressure does not lead to any further increase in CSA. Esophageal distensibility, defined as the change in the narrowest measurable CSA within the esophagus versus the intraluminal pressure, is significantly reduced in EoE patients compared
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