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Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer

BACKGROUND: Brain metastases (BM) is one of the most common failures of locally advanced non-small cell lung cancer (LA-NSCLC) after combined-modality therapy. The outcome of trials on prophylactic cranial irradiation (PCI) has prompted us to identify the highest-risk subset most likely to benefit f...

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Autores principales: Ding, Xiao, Dai, Honghai, Hui, Zhouguang, Ji, Wei, Liang, Jun, Lv, Jima, Zhou, Zongmei, Yin, Weibo, He, Jie, Wang, Luhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430600/
https://www.ncbi.nlm.nih.gov/pubmed/22846375
http://dx.doi.org/10.1186/1748-717X-7-119
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author Ding, Xiao
Dai, Honghai
Hui, Zhouguang
Ji, Wei
Liang, Jun
Lv, Jima
Zhou, Zongmei
Yin, Weibo
He, Jie
Wang, Luhua
author_facet Ding, Xiao
Dai, Honghai
Hui, Zhouguang
Ji, Wei
Liang, Jun
Lv, Jima
Zhou, Zongmei
Yin, Weibo
He, Jie
Wang, Luhua
author_sort Ding, Xiao
collection PubMed
description BACKGROUND: Brain metastases (BM) is one of the most common failures of locally advanced non-small cell lung cancer (LA-NSCLC) after combined-modality therapy. The outcome of trials on prophylactic cranial irradiation (PCI) has prompted us to identify the highest-risk subset most likely to benefit from PCI. Focusing on patients with completely resected pathological stage IIIA-N2 (pIIIA-N2) NSCLC, we aimed to assess risk factors of BM and to define the highest-risk subset. METHODS: Between 2003 and 2005, the records of 217 consecutive patients with pIIIA-N2 NSCLC in our institution were reviewed. The cumulative incidence of BM was estimated using the Kaplan–Meier method, and differences between the groups were analyzed using log-rank test. Multivariate Cox regression analysis was applied to assess risk factors of BM. RESULTS: Fifty-three (24.4 %) patients developed BM at some point during their clinical course. On multivariate analysis, non-squamous cell cancer (relative risk [RR]: 4.13, 95 % CI: 1.86–9.19; P = 0.001) and the ratio of metastatic to examined nodes or lymph node ratio (LNR) ≥ 30 % (RR: 3.33, 95 % CI: 1.79–6.18; P = 0.000) were found to be associated with an increased risk of BM. In patients with non-squamous cell cancer and LNR ≥ 30 %, the 5-year actuarial risk of BM was 57.3 %. CONCLUSIONS: In NSCLC, patients with completely resected pIIIA-N2 non-squamous cell cancer and LNR ≥ 30 % are at the highest risk for BM, and are most likely to benefit from PCI. Further studies are warranted to investigate the effect of PCI on this subset of patients.
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spelling pubmed-34306002012-08-30 Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer Ding, Xiao Dai, Honghai Hui, Zhouguang Ji, Wei Liang, Jun Lv, Jima Zhou, Zongmei Yin, Weibo He, Jie Wang, Luhua Radiat Oncol Research BACKGROUND: Brain metastases (BM) is one of the most common failures of locally advanced non-small cell lung cancer (LA-NSCLC) after combined-modality therapy. The outcome of trials on prophylactic cranial irradiation (PCI) has prompted us to identify the highest-risk subset most likely to benefit from PCI. Focusing on patients with completely resected pathological stage IIIA-N2 (pIIIA-N2) NSCLC, we aimed to assess risk factors of BM and to define the highest-risk subset. METHODS: Between 2003 and 2005, the records of 217 consecutive patients with pIIIA-N2 NSCLC in our institution were reviewed. The cumulative incidence of BM was estimated using the Kaplan–Meier method, and differences between the groups were analyzed using log-rank test. Multivariate Cox regression analysis was applied to assess risk factors of BM. RESULTS: Fifty-three (24.4 %) patients developed BM at some point during their clinical course. On multivariate analysis, non-squamous cell cancer (relative risk [RR]: 4.13, 95 % CI: 1.86–9.19; P = 0.001) and the ratio of metastatic to examined nodes or lymph node ratio (LNR) ≥ 30 % (RR: 3.33, 95 % CI: 1.79–6.18; P = 0.000) were found to be associated with an increased risk of BM. In patients with non-squamous cell cancer and LNR ≥ 30 %, the 5-year actuarial risk of BM was 57.3 %. CONCLUSIONS: In NSCLC, patients with completely resected pIIIA-N2 non-squamous cell cancer and LNR ≥ 30 % are at the highest risk for BM, and are most likely to benefit from PCI. Further studies are warranted to investigate the effect of PCI on this subset of patients. BioMed Central 2012-07-30 /pmc/articles/PMC3430600/ /pubmed/22846375 http://dx.doi.org/10.1186/1748-717X-7-119 Text en Copyright ©2012 Ding et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Ding, Xiao
Dai, Honghai
Hui, Zhouguang
Ji, Wei
Liang, Jun
Lv, Jima
Zhou, Zongmei
Yin, Weibo
He, Jie
Wang, Luhua
Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title_full Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title_fullStr Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title_full_unstemmed Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title_short Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lung cancer
title_sort risk factors of brain metastases in completely resected pathological stage iiia-n2 non-small cell lung cancer
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430600/
https://www.ncbi.nlm.nih.gov/pubmed/22846375
http://dx.doi.org/10.1186/1748-717X-7-119
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