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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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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. |
format | Online Article Text |
id | pubmed-3430600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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