Multivariate analysis of factors predictive of brain metastases in localised non-small cell lung carcinoma

Bajard, Agathe; Westeel, Virginie; Dubiez, A.; Jacoulet, P.; Pernet, D.; Dalphin, Jean‐Charles; Depierre, A

doi:10.1016/j.lungcan.2004.01.025

Cited by 112 publications

(103 citation statements)

References 24 publications

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“…15 Bajard et al showed that clinical T classification was significant for development of brain metastases in a cohort of 305 NSCLC patients (168 with stage I-II disease). 36 Similarly, in a study of 264 NSCLC patients at all stages (31% with stage I-II disease), Mujumoor and colleagues showed that the probability of developing metastases to the brain was significantly increased with increasing clinical tumor size. 38 In contrast, other studies have shown that for resected stage IIIA patients, pathologic T classification was not significantly associated with incidence of brain metasteses.…”

Section: Clinical and Pathologic Risk Factorsmentioning

confidence: 95%

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Factors associated with the development of brain metastases

Hubbs

Boyd

Hollis

et al. 2010

Cancer

115

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BACKGROUND The risk of developing brain metastases after definitive treatment of locally advanced nonsmall cell lung cancer (NSCLC) is approximately 30%-50%. The risk for patients with early stage disease is less defined. The authors sought to investigate this further and to study potential risk factors. METHODS The records of all patients who underwent surgery for T1-T2 N0-N1 NSCLC at Duke University between the years 1995 and 2005 were reviewed. The cumulative incidence of brain metastases and distant metastases was estimated by using the Kaplan-Meier method. A multivariate analysis assessed factors associated with the development of brain metastases. RESULTS Of 975 consecutive patients, 85% were stage I, and 15% were stage II. Adjuvant chemotherapy was given to 7%. The 5-year actuarial risk of developing brain metastases and distant metastases was 10%(95% confidence interval [CI], 8-13) and 34%(95% CI, 30-39), respectively. Of patients developing brain metastases, the brain was the sole site of failure in 43%. On multivariate analysis, younger age (hazard ratio [HR], 1.03 per year), larger tumor size (HR, 1.26 per cm), lymphovascular space invasion (HR, 1.87), and hilar lymph node involvement (HR, 1.18) were associated with an increased risk of developing brain metastases. CONCLUSIONS In this large series of patients treated surgically for early stage NSCLC, the 5-year actuarial risk of developing brain metastases was 10%. A better understanding of predictive factors and biological susceptibility is needed to identify the subset of patients with early stage NSCLC who are at particularly high risk. Cancer 2010;116:5038-46.

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Section: Clinical and Pathologic Risk Factorsmentioning

confidence: 95%

“…45 Histology was not a statistically significant factor in our series (P ¼ .14). Nonsquamous histology, adenocarcinoma in particular, has been associated with an increased risk of developing brain metastases in some, 33,34,38,39,46 but not all, [35][36][37] studies.…”

Section: Original Article 5042mentioning

confidence: 99%

Factors associated with the development of brain metastases

Hubbs

Boyd

Hollis

et al. 2010

Cancer

115

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“…This difference may be due to a more aggressive cancer in younger patients [5,57]. The odds ratio for brain metastasis associated with a young age (<50 or 60 years old, depending upon the study) compared to older age ranged from 1.26 (95% CI: 1.03-1.53) to 2.5(95%CI: 1.33-4.76) [189][190][191]. When older age was the reference in comparison to younger age, it had a protective effect that ranged from 0.5 (95%CI: 0.4-0.7) to 0.98 (95%CI: 0.97-0.99) [9,185,187,192,195].…”

Section: Risk Factorsmentioning

confidence: 98%

“…Although knowledge regarding modifiable risk factors is scarce, several nonmodifiable risk factors are known to influence the cumulative incidence of brain metastasis. Brain metastasis are more common in younger cancer patients than older cancer patients in breast cancer and melanoma [8,9,153,185,[187][188][189][190][191][192][193][194]. The risk of brain metastasis appears to increase until 40 to 49 years of age and then decline thereafter [131].…”

Section: Risk Factorsmentioning

confidence: 99%

“…A study conducted by Vuong et al [196] found males had a higher prevalence of brain metastasis than females (p<0.001), but the frequency of brain metastasis in a study conducted by Pickren et al [131] was not different (8.8% in men and 8.7% in women). Race has not been associated with brain metastasis [131] and was not included as a covariate in the majority of studies [8,9,185,187,[189][190][191][192][193][194][195][197][198][199][200][201][202][203][204]. Breast cancer is the most common source of brain metastasis for women [5].…”

Section: Risk Factorsmentioning

confidence: 99%

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Antidepressant use and risk of central nervous system metastasis

et al. 2016

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Risk factors for brain metastases in patients with non–small‐cell lung cancer

Wang

et al. 2018

Cancer Medicine

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Brain metastases (BM) are severe incidents in patients with non–small‐cell lung cancer (NSCLC). The controversial value of prophylactic cranial irradiation (PCI) in NSCLC in terms of survival benefit prompted us to explore the possible risk factors for BM in NSCLC and identify the potential population most likely to benefit from PCI. Risk factors for brain metastases in NSCLC are reviewed in this article. Identifying patients with a higher risk of BM could possibly increase the benefit of PCI while reducing the discomfort and risks caused by unnecessary invasive procedures in the NSCLC patient population. Future studies might focus on finding a solid basis for the prediction of the occurrence of brain metastases and for the therapeutic decision on the use of PCI.

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Multivariate analysis of factors predictive of brain metastases in localised non-small cell lung carcinoma

Cited by 112 publications

References 24 publications

Factors associated with the development of brain metastases

Factors associated with the development of brain metastases

Antidepressant use and risk of central nervous system metastasis

Risk factors for brain metastases in patients with non–small‐cell lung cancer

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