초록접수 현황
| 17F-048 | 구연 미채택시 포럼 발표 |
Outcomes of Surgical Treatment of Non-small Cell Lung Cancer with Synchronous Brain Metastasis
Tae Ho Kim¹, Hong Kwan Kim¹, Jung-Il Lee², Sumin Shin¹, Jong Ho Cho¹, Yong Soo Choi¹, Jhingook Kim¹, Jae Ill Zo¹, Young Mog Shim¹
¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., ²Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : The objective of this study was to examine the treatment outcomes and prognostic factors of patients undergoing surgical treatment for non-small cell lung cancer (NSCLC) with synchronous brain metastasis (BM).
Methods : Between 1998 and 2016, 70 patients underwent pulmonary resection for NSCLC despite the presence of synchronous BM at our institution. A retrospective review was performed and multivariate Cox regression analysis was used to determine the factors associated with survival outcomes.
Results : The mean age was 59 years (43 men, 61%). The most common histologic type was adenocarcinoma (n=52, 74%). Most patients had clinical T1-2 (n=62, 88%) and N0 (n=53, 76%) disease. The most common type of pulmonary resection was lobectomy (n=58, 83%). Treatment for BM included stereotactic radiosurgery in 50 patients (71%) and metastasectomy in 13 (19%). Most patients had pathologic T1-2 disease (n=59, 84%). Pathologic N stage was N0 in 36 patients (52.2%), N1 in 13 (18.8%), and N2 in 20 (29%). Postoperative complications and in-hospital mortality occurred in 30 patients (43%) and 1 (1.4%), respectively. With a mean follow-up of 46 months, median overall survival(OS) and recurrence-free survival(RFS) were 38 months and 10 months, respectively. Early pathologic T and N stages and lobectomy were independent prognostic factors associated with better OS. Adjuvant treatment was the only independent prognostic factor associated with better RFS.
Conclusion : Surgical treatment of NSCLC with synchronous BM could be performed with acceptable early and late outcomes in selected patients. Patients undergoing lobectomy for early-stage primary tumor with no mediastinal lymphadenopathy showed more favorable survival.
Methods : Between 1998 and 2016, 70 patients underwent pulmonary resection for NSCLC despite the presence of synchronous BM at our institution. A retrospective review was performed and multivariate Cox regression analysis was used to determine the factors associated with survival outcomes.
Results : The mean age was 59 years (43 men, 61%). The most common histologic type was adenocarcinoma (n=52, 74%). Most patients had clinical T1-2 (n=62, 88%) and N0 (n=53, 76%) disease. The most common type of pulmonary resection was lobectomy (n=58, 83%). Treatment for BM included stereotactic radiosurgery in 50 patients (71%) and metastasectomy in 13 (19%). Most patients had pathologic T1-2 disease (n=59, 84%). Pathologic N stage was N0 in 36 patients (52.2%), N1 in 13 (18.8%), and N2 in 20 (29%). Postoperative complications and in-hospital mortality occurred in 30 patients (43%) and 1 (1.4%), respectively. With a mean follow-up of 46 months, median overall survival(OS) and recurrence-free survival(RFS) were 38 months and 10 months, respectively. Early pathologic T and N stages and lobectomy were independent prognostic factors associated with better OS. Adjuvant treatment was the only independent prognostic factor associated with better RFS.
Conclusion : Surgical treatment of NSCLC with synchronous BM could be performed with acceptable early and late outcomes in selected patients. Patients undergoing lobectomy for early-stage primary tumor with no mediastinal lymphadenopathy showed more favorable survival.
책임저자: Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Tae Ho Kim, E-mail : roohoguy@gmail.com