Prognostic Factors in Lung Adenocarcinoma with Brain Metastasis

Abstract

Introduction: Brain metastasis (BM) is significantly seen in lung adenocarcinoma and adversely affects survival. We aimed to evaluate the factors affecting the prognosis in patients with BM diagnosed with lung adenocarcinoma. Materials and Methods: Patients with BM between 2012 and 2022 were reviewed retrospectively. Demographic characteristics of the patients, primary tumor characteristics, presence of mutation, BM number, localization, size, development time, and treatment characteristics were evaluated. Inflammatory indices at the time of BM were examined. The overall survival time was calculated. Results: About 92.9% of 113 patients were male, the median age was 62 years (54.5–68.5), and follow-up was 8 months (3–18). BM was detected at the time of diagnosis in 62 (54.9%) of the patients, whereas BM developed later in 51 (45.1%) patients. Systemic treatment was applied to 72.5% of the patients. Survival was lower in patients with BM at diagnosis (4 vs. 14 months, P < 0.001). Primary tumor maximum standardized uptake value level was higher on fluorodeoxyglucose-positron emission tomography-computed tomography at diagnosis in patients with late BM (P = 0.004). The development time of BM was 9 months (4–16), and the median survival was 8 months (6.2–9.8). There was no difference between tumor localization or inflammatory indices and the development of BM and prognosis. The presence of BM at diagnosis and lack of systemic treatment were found to be factors that independently reduced survival (P < 0.001, P = 0.007). Conclusion: The presence of BM at diagnosis significantly reduces survival. It has been observed that systemic treatments applied in addition to local treatments have a positive effect on the prognosis.