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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Clinical determinants impacting overall survival of patients with operable brain metastases from non-small cell lung cancer

Klinische Faktoren, die das Gesamtüberleben von Patienten mit operablen Hirnmetastasen bei nicht-kleinzelligem Lungenkrebs beeinflussen

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  • Andras Piffko - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Benedikt Asey - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Lasse Dührsen - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Inka Ristow - Universitätsklinikum Hamburg-Eppendorf, Klinik für Radiologie, Hamburg, Deutschland
  • Johannes Salamon - Universitätsklinikum Hamburg-Eppendorf, Klinik für Radiologie, Hamburg, Deutschland
  • Harriet Wikman-Kocher - Universitätsklinikum Hamburg-Eppendorf, Institut für Tumorbiologie, Hamburg, Deutschland
  • Cecile Maire - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Katrin Lamszus - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Manfred Westphal - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Thomas Sauvigny - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • presenting/speaker Malte Mohme - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV161

doi: 10.3205/22dgnc159, urn:nbn:de:0183-22dgnc1592

Published: May 25, 2022

© 2022 Piffko et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Non-small cell lung cancer (NSCLC) is currently the leading cause of cancer related deaths worldwide and is accompanied by a continuously increasing incidence of brain metastases (BM). The recent improvements of systemic treatment in NSCLC necessitates continuous updates on prognostic subgroups and overall survival curves. In order to improve clinical decision making in tumor boards, we investigated the clinical determinants affecting survival in patients with resectable NSCLC BM.

Methods: A retrospective analysis was conducted of NSCLC patients with surgically resected BM treated in our institution between 01/2015 und 12/2020. Relevant clinical factors affecting survival were identified by univariate analysis and included in a multivariate cox regression model. The study was approved by the ethic committee (PV4904).

Results: Overall, 264 patients were identified, with a mean age of 62.39 ±9.98 years at initial diagnosis of NSCLC BM. Factors that significantly affected overall survival included the systemic metastatic load at time of initial diagnosis of BM (mean: 45.9 ±9.7 vs. 58.9 ±9.4 months, p = 0.021) as well as number of BM <2 (mean: 25.5 ±4.4 vs. 57.4 ±7.8 months, p = 0.014). We adjusted for survival time after neurosurgical intervention and found significant survival benefits in patients <60 years (32.5 ±4.3 vs. 28.5 ±5.2 months, p = 0.036) and patients without any concurrent systemic metastases at time of NSCLC BM diagnosis (mean 32.4 vs. 34.1, p = 0.032). Our data shows that number of BM (singular/solitary), gender and age, but not location (infra-/supratentorial), mass-edema index and time to BM occurrence seem to impact overall survival in NSCLC BM patients.

Conclusion: Our study shows that patients in prognostically favorable clinical subgroups have an overall survival which differs significantly from the current state of literature and strongly supports the positive impact of surgical intervention. These clinically relevant factors may improve the understanding of the risks, the course of this disease and hopefully impact future clinical decision making in tumor boards.