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J.Y. Hong



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    P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.12-018 - Brain metastases as a first site of recurrence in surgically resected non-small-cell lung cancer (ID 2755)

      09:30 - 09:30  |  Author(s): J.Y. Hong

      • Abstract

      Background
      With improved survival after multimodality treatment in surgically resected non-small-cell lung cancer (NSCLC), the incidence of brain metastases as a first site of recurrence has increased. We analyzed the characteristics and prognostic factors in patients with postoperative brain metastases as a first site of relapse in surgically resected NSCLC, focusing on difference between patients with brain only metastases (B) and patients with brain and extracranial systemic metastases (BS) simultaneously.

      Methods
      We retrospectively analyzed patients with surgically resected NSCLC at Samsung Medical Center (SMC) between 2004 and 2010. Clinicopathological parameters and prognostic factors between two groups (brain only metastases vs brain and extracranial sites) were reviewed. Interval to brain metastases as a first site of relapse after surgery and overall survival after brain recurrence was calculated.

      Results
      Of the 3134 patients with surgically resected NSCLC, 106 (3.4%) patients developed postoperative brain metastases as a first site of recurrence. Among them, 73 patients (2.3%) relapsed in B and 33 patients (1.1%) were in BS simultaneously. Median time to brain metastases as a first site of relapse after surgery was 11 months (range 0-54 months). Most common histologic subtype was adenocarcinoma (n=65, 61.3%) and large number of patients had IIIa disease (n=56, 52.8%). Single brain metastases were observed in 42 patients (39.4%) and local treatments were performed in 102 patients (96.2%). The baseline characteristics between two groups (B vs BS) were not significantly different. Among 73 (brain only), 8 patients (11%) received systemic treatment as well as local treatment and 16 patients (21.9%) developed extracranial systemic metastases after brain relapse. The median interval time to extracranial systemic metastases after brain relapse was 10 months (range 0-27 months). The overall survival following B and BS was 30 months and 13 months, respectively (P=0.004). Significantly favorable prognostic factor for survival in patients with brain only metastases included single brain metastases whereas adenocarcinoma was associated with good prognosis in patients with BS.

      Conclusion
      Our results suggested that brain metastasis is common site of metastasis after surgery and patients who develop brain only metastases after curative resection of NSCLC show favorable prognosis with local treatment.