Author of

• 10850

  +

  P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10858

    +

    P1.12-008 - The effects of different preoperative brain survey strategy on the pathological stage I non-small cell lung cancer patients (ID 1396)

    09:30 - 09:30  |  Author(s): J. Hung
    • Abstract

    Background
    Brain metastasis is rare in pathological stage I non-small cell lung cancer (NSCLC). Brain magnetic resonance imaging (MR) should discover more synchronous asymptomatic brain metastasis than computed tomography (CT), but the efficacy of brain MR in pathological stage I NSCLC is not yet determined. This study aimed to investigate the effect of different strategies for preoperative brain imaging survey of pathological stage I NSCLC underwent complete resection.

    Methods
    The clinicopathological characteristics of 870 patients underwent complete resection of stage I NSCLC at Taipei Veterans General Hospital between Jan. 2002 and Dec. 2011 were retrospectively reviewed. The patients were divided into three groups according to pre-operative brain survey strategy (no imaging study, CT, or MR). Multivariate analysis for survival was done.

    Results
    In total 870 patients, 446 patients with no brain imaging study, 304 had brain CT and 120 had brain MR. Median age was 65±11.36. Average tumor size was 2.2±1.07, 2.8±1.16 and 2.4±1.01 centimeters in the three groups, respectively. 238, 103 and 544 patients were pathological T1a, T1b and T2a, respectively. Adenocarcinoma was identified in 716(82.3%) patients, while 94(10.8%) had squamous cell carcinoma. With median follow up time of 42.3 months, 21 (2.4%) brain metastases in 870 patients after complete resection were identified, with 7(1.5%), 10(3.3%) and 4(3.3%) patients in each group, respectively (p = 0.027). Within the first year and the second year follow-up, 2 and 11 brain metastases were noted, respectively. In subgroup analysis, 3 patients with brain metastases had pathological T1a, 1 had T1b, and 17 had T2a. The overall 5-year survivals were 76.9%, 72.0% and 85.4% in non-imaging, CT and MR group, respectively (p = 0.014). Disease free survival of each group were 84.1%, 84.0% and 83.4% (p = 0.167). Under multivariate analysis adjusted with age, gender, T stage, pathohistological grading, pleural invasion status and whether patient receiving whole body PET/CT, there were 3 factors associated with poorer survival: age, male sex and T stage. Brain survey strategy did not affect survival in multivariate analysis. Figure 1

    Conclusion
    Preoperative brain MR survey did not have a less frequent rate of brain metastasis comparing with non-imaging and brain CT strategy, nor a better survival in pathological stage I NSCLC patients. Use brain MR in preoperative staging routinely in clinical stage I patients should be reconsidered, especially in NSCLC with smaller tumor size.