Universität zu Köln

Juenger, Stephanie T., Schoedel, Petra, Ruess, Daniel, Ruge, Maximilian, Brand, Julia-Sarita, Wittersheim, Maike, Eich, Marie-Lisa ORCID: 0000-0002-8601-4598, Schmidt, Nils-Ole, Goldbrunner, Roland, Grau, Stefan ORCID: 0000-0002-9742-527X and Proescholdt, Martin (2020). Timing of Development of Symptomatic Brain Metastases from Non-Small Cell Lung Cancer: Impact on Symptoms, Treatment, and Survival in the Era of Molecular Treatments. Cancers, 12 (12). BASEL: MDPI. ISSN 2072-6694

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Abstract

Simple Summary In order to clarify whether an early development of brain metastases from non-small cell lung cancer represents a poor prognostic factor for further survival we analyzed 377 patients with brain metastases, treated by radiosurgery or surgery at two German institutions. Our results show that an early appearance of brain metastasis does not influence further survival in a comprehensive treatment setting. Objective: We attempted to analyze whether early presentation with brain metastases (BM) represents a poor prognostic factor in patients with non-small cell lung cancer (NSCLC), which should guide the treatment team towards less intensified therapy. Patients and methods: In a retrospective bi-centric analysis, we identified patients receiving surgical treatment for NSCLC BM. We collected demographic-, tumor-, and treatment-related parameters and analyzed their influence on further survival. Results: We included 377 patients. Development of BM was precocious in 99 (26.3%), synchronous in 152 (40.3%), and metachronous in 126 (33.4%) patients. The groups were comparable in terms of age (p = 0.76) and number of metastases (p = 0.11), and histology (p = 0.1); however, mutational status significantly differed (p = 0.002). The precocious group showed the worst clinical status as assessed by Karnofsky performance score (KPS) upon presentation (p < 0.0001). Resection followed by postoperative radiotherapy was the predominant treatment modality for precocious BM, while in syn- and metachronous BM surgical and radio-surgical treatment was balanced. Overall survival (OS) did not differ between the groups (p = 0.76). A good postoperative clinical status (KPS >= 70) and the application of any kind of adjuvant systemic therapy were independent predictive factors for OS. Conclusion: Early BM presentation was not associated with worse OS in NSCLC BM patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Juenger, Stephanie T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoedel, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Brand, Julia-Sarita UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittersheim, Maike UNSPECIFIED UNSPECIFIED UNSPECIFIED Eich, Marie-Lisa UNSPECIFIED orcid.org/0000-0002-8601-4598 UNSPECIFIED Schmidt, Nils-Ole UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED orcid.org/0000-0002-9742-527X UNSPECIFIED Proescholdt, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-309711
DOI:	10.3390/cancers12123618
Journal or Publication Title:	Cancers
Volume:	12
Number:	12
Date:	2020
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2072-6694
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PARTITIONING ANALYSIS RPA; PROGNOSTIC-FACTORS; SURGICAL-TREATMENT Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/30971