Prognostic factors and outcome of surgically treated patients with brain metastases of non‐small cell lung cancer

Abstract

BackgroundBrain metastases (BM) are a common consequence of lung cancer and surgery is effective; however, the factors affecting survival after surgery are unclear. The aim of this study was to identify the outcomes and prognoses of post‐metastasectomy patients with BM from non‐small cell lung cancer (NSCLC) at a single institution over a 15‐year period.MethodsNSCLC patients who had undergone BM surgery were retrospectively identified. Survival was analyzed using the Kaplan–Meier curve, and univariate and multivariate factors associated with survival were identified using the Cox proportional hazards model.ResultsThe median overall survival was 9.8 months, 18 (14.8%) patients survived > 24 months, and 6 (4.9%) > 36 months. The one and two‐year survival rates were 41% and 18.6%, respectively. Univariate analysis revealed that recursive partitioning analysis (RPA) classification, Karnofsky Performance Scale (KPS) scores, BM number, extracranial metastasis status, different lesion locations, resection extent, postoperative treatment, and salvage therapy after recurrence significantly influenced patient survival. The different treatment modalities for primary lesions also affected postoperative survival. KPS ≥ 70, RPA class I/II, and postoperative chemotherapy were independent factors that decreased the risk of death from BM. Interestingly, the initial onset of intracranial lesions could increase the risk of death from BM.ConclusionA KPS score ≥ 70, RPA class I/II, and postoperative chemotherapy could benefit post‐metastasectomy patients with BM from NSCLC. Conversely, the initial onset of intracranial lesions is an unfavorable factor that increases the risk of death. These findings support the use of personalized therapy for patients with BM from NSCLC.

A novel online calculator predicting short-term postoperative outcomes in patients with metastatic brain tumors

“…Our results demonstrate a significant, independent association between KPS score and LOS, discharge disposition, and hospital charges. While research has shown KPS to be strongly associated with overall and progress-free survival among metastatic brain tumor patients, there has been limited research into how well KPS can prognosticate high-value care outcomes [ 28 , 29 ]. To our knowledge, the present study is the first to utilize KPS to predict individualized risk of high-value care outcomes specifically among patients undergoing surgical treatment of metastatic brain tumors.…”

Development and validation of a novel nomogram for predicting overall survival of lung cancer patients treated with immune checkpoint inhibitors: A retrospective cohort study in China

“…The KPS assesses patients' functional status. A KPS of more than 80 indicates that patients can take care of themselves (She et al 2019). When patients' KPS is below 70, ICIs should be used with caution (Thompson et al 2022).…”

Oncogenic driver mutations in Swiss never smoker patients with lung adenocarcinoma and correlation with clinicopathologic characteristics and outcome

“…The initial onset of brain metastases is generally considered an unfavorable prognostic factor that increases the risk of death [35]. In a recent study, Korpanty et al [1] found no significant survival difference in patients with and those without brain metastases at diagnosis.…”