Risk factors of brain metastasis of lung squamous cell carcinoma: a retrospective analysis of 188 patients from single center

Abstract

Background: To explore risk factors and the efficacy of treatment strategies for brain metastasis (BM) in squamous cell carcinoma (SCC) of the lung. Methods: The clinical data of 188 pathologically confirmed as squamous cell carcinoma or adenosquamous carcinoma patients were studied retrospectively. Factors including age (<60 vs. ≥60), gender, stage at diagnosis, T status (T1-2 vs. T3-4), N status (N0-1 vs. N2-3), histology (squamous vs. adenosquamous), smoking history (non-smoker vs. current smoker) and serum tumor markers (normal vs. elevated) were analyzed. Results: The incidence of BM was 19.1% (36/188) in our cohort. Patients who were female (p = 0.005), had advanced disease at diagnosis (p < 0.001), had adenosquamous carcinoma histology (p = 0.033) or had elevated serum level of CEA at diagnosis (p < 0.001) had significantly higher incidence of BM. In multivariate analysis, female (p = 0.034, HR = 18.874) and elevated serum level of CEA at diagnosis (p = 0.009, HR = 19.824) were independent risk factors of BM. BM patients who received additional systemic therapy after local therapy had significantly longer post-BM survival than those who received local therapy only (p = 0.004, HR = 0.058). Gemcitabine/platinum-containing regimen (GP) and taxans/platinum-containing regimen (TP) led to comparable brain-metastasis-free survival (BMFS) (p = 0.10). Conclusions: Females and patients with elevated serum level of CEA at diagnosis had a higher risk of developing BM. The following systemic therapy after local therapy prolonged the survival of BM patient, but the efficacy of GP and TP was comparable in terms of preventing BM.

Dual Primary Squamous Cell Carcinoma of the Lung and Adenocarcinoma Rectal

“…It was found that 40% of NSCLC patients had brain metastases. 14 Based on a study by He, et al (2021), 39% of lung squamous cell carcinoma patients had brain metastases. 15 Li, et al (2017) said that females and high CEA levels are factors associated with the incidence of brain metastases.…”

“…14 Based on a study by He, et al (2021), 39% of lung squamous cell carcinoma patients had brain metastases. 15 Li, et al (2017) said that females and high CEA levels are factors associated with the incidence of brain metastases. 14 Both factors are consistent with the patient in this case report.…”

“…15 Li, et al (2017) said that females and high CEA levels are factors associated with the incidence of brain metastases. 14 Both factors are consistent with the patient in this case report. Iwasaki, et al (2004) reported that the 3-year survival rate of patients with high CEA was 0%, and the 3-year survival rate of patients with normal CEA was 39.6%.…”

“…Warren and Gates (1932) proposed criteria that the diagnosis of dual primary carcinoma requires the following: (1) each tumor must present a definite picture of malignancy; (2) each tumor must be distinct histologically; and (3) the possibility that one is metastatic to the other must be ruled out. [7][8][9][10][11][12][13][14][15][16][17][18] The biopsy showed squamous cell carcinoma of the lung and adenocarcinoma of the colon. This proved that the two cancers are histologically different.…”