Prognostic impacts of extracranial metastasis on non‐small cell lung cancer with brain metastasis: A retrospective study based on surveillance, epidemiology, and end results database

Abstract

This study was designed to investigate the prognostic value of the number and sites of extracranial metastasis (ECM) in NSCLC patients with BM. NSCLC patients with BM from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015 were enrolled in analysis. Patients from 2010 to 2013 were included in the training set and those from 2014 to 2015 in the validation set. ECM sites among different subtypes of NSCLC were compared by Chi‐square tests. Kaplan–Meier methods and Cox regression models were performed to analyze survival data. Competing‐risks analysis was used to predict cumulative incidence rates for CSS and non‐CSS cause. We included 5974 patients in the training cohort and 3561 patients in the validation cohort. Most (nearly 80%) NSCLC patients with BM showed 0–1 involved extracranial organ, with the most and least common ECM organ being bone and distant lymph nodes (DLNs) among all subtypes of NSCLC, respectively. The number of involved extracranial organs was an independent prognostic factor for patients with BM from NSCLC ( p < 0.001). Patients with 0–1 ECM had better survival than those with larger number of involved extracranial organs ( p < 0.001). Cumulative incidence rates for CSS were increased with the number of ECM raising ( p < 0.001). All involved extracranial organs were associated with worse survival ( p < 0.05). In patients with single‐organ ECM, we observed a better prognosis in lung and bone metastasis, while liver metastasis showed worst survival. But the difference in survival in these patient groups was relatively small. Patients with liver metastasis had higher cumulative incidence rates for CSS than that in patients with lung and bone metastasis ( p < 0.05). More extracranial metastases were associated with poor prognosis in NSCLC patients with BM and ECM sites showed limited effect on survival. Tailored treatments would be reasonable for BM patients from NSCLC with different metastasis patterns.

Risk Factors, Prognosis, and a New Nomogram for Predicting Cancer-Specific Survival Among Lung Cancer Patients with Brain Metastasis: A Retrospective Study Based on SEER

“…The research on the prognosis of brain metastasis patients among lung cancer could provide guidance for clinicians in the treatment and management of patients with lung cancer. Previous epidemiological researches have shown that patients with brain metastasis among lung cancer had a very short survival time (7,17), and our study also showed a high mortality among patients with brain metastasis from lung cancer. We found the 1-year overall survival rate was only 28% among patients with brain metastasis, and the median OS time of these patients is 6.05 months, consistent with the results of other studies (18).…”

“…In order to estimate the prognosis of intracranial metastasis among lung cancer, Sperduto PW et al updated the graded prognostic assessment of lung cancer with brain metastasis using the molecular markers (Lung-molGPA) (6). In addition, a retrospective study investigated the in uence of extracranial metastasis on prognosis of NSCLC with intracranial metastasis based on Surveillance, Epidemiology, and End results (SEER) database (7). Although there are many studies on the risk factors and prognosis of brain metastasis among lung cancer patients, these studies mainly focused on NSCLC, or only limited to the impacts of some speci c factors on the prognosis of lung cancer patients with brain metastasis.…”

The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database

“…The poor prognosis of brain metastatic lung cancer has always been a concern. However, most studies focus on the long-term survival of lung cancer patients with brain metastases, the early death of these patients has not been explored [19][20][21][22]. The definition of early death varies from studies and is usually defined as 30 days to 3 months after diagnosis.…”

Identification of a high-risk group for brain metastases in non-small cell lung cancer patients

“…Lung cancer (LC) is the most common malignancy and a leading cause of cancer-related death (1). Up to 25-50% of non-small cell lung cancer (NSCLC) patients will develop brain metastases (BM) during their disease course (2), and LC is the most frequent primary tumor to metastasize to the brain (3). BM contribute substantially to the overall cancer mortality because patients with BM usually have a poor prognosis despite multimodal treatments and advances in systemic therapies (3).…”