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. 2021 Oct;26(10):1840-1846.
doi: 10.1007/s10147-021-01969-x. Epub 2021 Jun 24.

Osteogenic and brain metastases after non-small cell lung cancer resection

Tetsuya Mizuno  1 , Hayato Konno  2 , Toshiyuki Nagata  2 , Mitsuhiro Isaka  2 , Yasuhisa Ohde  2
Affiliations

Osteogenic and brain metastases after non-small cell lung cancer resection

Tetsuya Mizuno et al. Int J Clin Oncol. 2021 Oct.

Abstract

Background: A significant number of non-small cell lung cancer (NSCLC) patients develop osteogenic metastases (OMs) and/or brain metastases (BMs) after surgery, however, routine chest computed tomography (CT) sometimes fails to diagnose these recurrences. We investigated the incidence of BMs and OMs after pulmonary resection and aimed to identify candidates who can benefit from brain magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in addition to CT.

Methods: We retrospectively reviewed medical records of 1099 NSCLC patients who underwent pulmonary resection between 2002 and 2013. Clinicopathological factors associated with OM and/or BM were investigated using univariate and multivariate analyses.

Results: Postoperative recurrence occurred in 344 patients (32.6%). OMs were diagnosed in 56 patients (5.6%) with 93% within 3 years. BMs were identified in 72 patients (6.6%) with 91.1% within 3 years. Multivariate analysis revealed that poorly differentiated tumor and the presence of pathological nodal metastases were significantly associated with postoperative BM (p = 0.037, < 0.001), preoperative serum carcinoembryonic antigen (CEA) level of 5 ng/mL or higher and the presence of pathological nodal metastases were significantly associated with OM (p = 0.034, < 0.001). The prevalence of OM and/or BM in 5 years was as high as 25.9% in patients with pathological nodal metastases.

Conclusions: We identified significant predictive factors of postoperative BM and OM. Under patient selection, the effectiveness of intensive surveillance for the modes of recurrence should be investigated with respect to earlier detection, maintenance of quality of life, and survival outcomes.

Keywords: Brain metastasis; Lung cancer; Osteogenic metastasis; Postoperative surveillance.

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References

    1. Izar B, Sequist L, Lee M et al (2013) The impact of EGFR mutation status on outcomes in patients with resected stage I non-small cell lung cancers. Ann Thorac Surg 96(3):962–968 - DOI
    1. Sugimura H, Nichols FC, Yang P et al (2007) Survival after recurrent nonsmall-cell lung cancer after complete pulmonary resection. Ann Thorac Surg 83(2):409–417 - DOI
    1. Kudo Y, Shimada Y, Saji H et al (2015) Prognostic factors for survival after recurrence in patients with completely resected lung adenocarcinoma: important roles of epidermal growth factor receptor mutation status and the current staging system. Clin Lung Cancer 16(6):e213-221 - DOI
    1. Lou F, Sima CS, Rusch VW et al (2014) Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer. Ann Thorac Surg 98(5):1755–1760 - DOI
    1. Shimada Y, Saji H, Yoshida K et al (2013) Prognostic factors and the significance of treatment after recurrence in completely resected stage I non-small cell lung cancer. Chest 143(6):1626–1634 - DOI

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