Identification of predictors for brain metastasis in newly diagnosed non-small cell lung cancer: a single-center cohort study

e20572 Background: We performed a large-scale, retrospective, nationwide, cohort study of the incidence of brain metastasis in patients with advanced non-small-cell lung cancer (NSCLC) according to the systemic treatment administered. Methods: The data were extracted from the Health Insurance Review and Assessment Service of Korea database from January 1, 2011 to November 30, 2016. Of the 29,224 patients newly diagnosed with stage IIIB or IV NSCLC who received first-line cytotoxic chemotherapy (CC group) or targeted therapy (TT group), 22,508 patients without brain metastasis were analyzed. Results: In total, 1,131 (5.0%) patients subsequently developed brain metastasis. The overall cumulative incidence of brain metastasis was significantly higher in the TT group than in the CC group (1-year cumulative incidence: 8.7 ± 0.6% vs. 3.8 ± 0.3%; 3-year: 17.2 ± 0.7% vs. 5.0 ± 0.3%, respectively; P < 0.001), despite the higher rate of brain metastasis in the CC group at < 3 years after diagnosis. Younger age, female sex, living in a rural area, anticoagulant use, and first-line TT (relative risk, 2.17 ± 0.03; 95% confidence interval, 1.92–2.50, P < 0.0001) retained significant associations with subsequent brain metastasis after adjusting for all variables. Conclusions: In the Korean population, the overall cumulative incidence of brain metastasis was significantly higher in patients in the TT group than in those in the CC group; the former could be regarded as having mutations in the EGFR or ALK gene.

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Safety and Feasibility of Video-Assisted Thoracoscopic Day Surgery and Inpatient Surgery in Patients With Non-small Cell Lung Cancer: A Single-Center Retrospective Cohort Study

Frontiers in Surgery ◽

10.3389/fsurg.2021.779889 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yingxian Dong ◽

Cheng Shen ◽

Yan Wang ◽

Kun Zhou ◽

Jue Li ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Day Surgery ◽

Small Cell ◽

Single Center ◽

Small Cell Lung ◽

Video Assisted

Background and Objective: This study was undertaken to evaluate how safe and viable the use of video-assisted thoracoscopic day surgery (VATDS) is for individuals diagnosed with early-stage non-small cell lung cancer (NSCLC).Methods: Data obtained from the selected patients with NSCLC who underwent video-assisted thoracoscopic surgery (VATS) in the same medical group were analyzed and a single-center, propensity-matched cohort study was performed. In total, 353 individuals were included after propensity score matching (PSM) with 136 individuals in the day surgery group (DSG) and 217 individuals in the inpatient surgery group (ISG).Results: The 24-h discharge rate in the DSG was 93.38% (127/136). With respect to the postoperative complications (PPCs), no difference between the two groups was found (DSG vs. ISG: 11.76 vs. 11.52%, p = 0.933). In the DSG, a shorter length of stay (LOS) after surgery (1.47 ± 1.09 vs. 2.72 ± 1.28 days, p < 0.001) and reduced drainage time (8.45 ± 3.35 vs. 24.11 ± 5.23 h, p < 0.001) were found, while the drainage volume per hour (mL/h) was not notably divergent between the relevant groups (p = 0.312). No difference was observed in the cost of equipment and materials between the two groups (p = 0.333). However, the average hospital cost and drug cost of the DSG were significantly lower than those of the ISG (p < 0.001).Conclusion: The study indicated that the implementation of VATDS showed no difference in PPCs, but resulted in shorter in-hospital stays, shorter drainage times, and lower hospital costs than inpatient surgery. These results indicate the safety and feasibility of VATDS for a group of highly selected patients with early-stage NSCLC.

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Effect of Cerebral Infarction on the Risk of Synchronous Brain Metastasis: Analysis of 307 Consecutive Patients of Newly Diagnosed Non-Small Cell Lung Cancer

Clinical Oncology and Research ◽

10.31487/j.cor.2020.05.07 ◽

2020 ◽

pp. 1-6

Author(s):

Haijun Zhang ◽

Dandan Zhou ◽

Haijun Zhang ◽

Hongming Zhang ◽

Wenwen Xu

Keyword(s):

Lung Cancer ◽

Brain Metastasis ◽

Cerebral Infarction ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Clinicopathological Parameters ◽

Newly Diagnosed ◽

Small Cell Lung ◽

Nsclc Patients

Background: Brain metastasis (BM) is a common complication of patients with non-small cell lung cancer (NSCLC) and associated with a poor prognosis. The study aimed to evaluate the effect of cerebral infarction (CI) on the risk of BM in NSCLC for preventive therapy strategy. Methods: 307 patients with newly diagnosed NSCLC in Zhongda Hospital, Medical School of Southeast University from July 2013 to July 2018 were retrospectively analyzed. Depending on magnetic resonance imaging (MRI), the patients were divided into the BM group and the control group (without BM). Then, the prevalence of CI and baseline clinicopathological parameters were evaluated and compared between the two groups. Results: Out of the 307 patients, 204 patients (66.4%) had CI, and 52 patients (16.9%) had BM. Especially, the prevalence of CI in the NSCLC patients with BM was 84.6%, which was significantly higher than that of 62.7% in the NSCLC patients without BM (p = 0.002). Following univariate logistic regression analysis and the multivariate model, the results demonstrated that CI was a significant independent risk factor for BM in NSCLC (odds rate [OR], 2.921; 95% confidence interval [CI], 1.242-6.873; p = 0.014). Moreover, CI contributed to a worse prognosis in NSCLC patients with BM. Finally, dynamical trace confirmed CI could promote BM in NSCLC patients. Conclusions: CI could be associated with a metastatic tropism to the brain and then with an increased risk of BM in NSCLC patients. Therefore, the targeted intervention of the metastatic niche of CI could offer a promising approach for the prevention, prognostic evaluation, and therapy of BM in NSCLC patients for better clinical outcomes.

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