Incidence Proportions of Brain Metastases in Patients Diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System

Purpose Population-based estimates of the incidence of brain metastases are not generally available. The purpose of this study was to calculate population-based incidence proportions (IPs) of brain metastases from single primary lung, melanoma, breast, renal, or colorectal cancer. Patients and Methods Patients diagnosed with single primary lung, melanoma, breast, renal, or colorectal cancer (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System (MDCSS) were used for analysis. IP of brain metastases by primary site and variable of interest (race, sex, age at diagnosis of primary cancer, and Surveillance, Epidemiology, and End Results [SEER] stage of primary cancer) was calculated with 95% CIs. Results Total IP percentage (IP%) of brain metastases was 9.6% for all primary sites combined, and highest for lung (19.9%), followed by melanoma (6.9%), renal (6.5%), breast (5.1%), and colorectal (1.8%) cancers. Racial differences were seen with African Americans demonstrating higher IP% of brain metastases compared with other racial groups for most primary sites. IP% was significantly higher for female patients with lung cancer, and significantly higher for male patients with melanoma. The highest IP% of brain metastases occurred at different ages at diagnoses: age 40 to 49 years for primary lung cancer; age 50 to 59 years for primary melanoma, renal, or colorectal cancers; and age 20 to 39 for primary breast cancer. IP% significantly increased as SEER stage of primary cancer advanced for all primary sites. Conclusion Total IP% of brain metastases was lower than previously reported, and it varied by primary site, race, sex, age at diagnosis of primary cancer, and SEER stage of primary cancer.

Download Full-text

Increased risk of secondary lung cancer in patients with tuberculosis: A nationwide, population-based cohort study

PLoS ONE ◽

10.1371/journal.pone.0250531 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250531

Author(s):

Li-Ju Ho ◽

Hung-Yi Yang ◽

Chi-Hsiang Chung ◽

Wei-Chin Chang ◽

Sung-Sen Yang ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Large Scale ◽

Primary Lung Cancer ◽

Significant Risk ◽

Population Based ◽

Chronic Obstructive ◽

Primary Cancer ◽

Increased Risk ◽

Subsequent Risk

Background Tuberculosis (TB) presents a global threat in the world and the lung is the frequent site of metastatic focus. A previous study demonstrated that TB might increase primary lung cancer risk by two-fold for more than 20 years after the TB diagnosis. However, no large-scale study has evaluated the risk of TB and secondary lung cancer. Thus, we evaluated the risk of secondary lung cancer in patients with or without tuberculosis (TB) using a nationwide population-based dataset. Methods In a cohort study of 1,936,512 individuals, we selected 6934 patients among patients with primary cancer and TB infection, based on the International Classification of Disease (ICD-p-CM) codes 010–011 from 2000 to 2015. The control cohort comprised 13,868 randomly selected, propensity-matched patients (by age, gender, and index date) without TB exposure. Using this adjusted date, a possible association between TB and the risk of developing secondary lung cancer was estimated using a Cox proportional hazards regression model. Results During the follow-up period, secondary lung cancer was diagnosed in 761 (10.97%) patients with TB and 1263 (9.11%) patients without TB. After adjusting for covariates, the risk of secondary lung cancer was 1.67 times greater among primary cancer in the cohort with TB than in the cohort without TB. Stratification revealed that every comorbidity (including diabetes, hypertension, cirrhosis, congestive heart failure, cardiovascular accident, chronic kidney disease, chronic obstructive pulmonary disease) significantly increased the risk of secondary lung cancer when comparing the TB cohort with the non-TB cohort. Moreover, the primary cancer types (including head and neck, colorectal cancer, soft tissue sarcoma, breast, kidney, and thyroid cancer) had a more significant risk of becoming secondary lung cancer. Conclusion A significant association exists between TB and the subsequent risk for metastasis among primary cancers and comorbidities. Therefore, TB patients should be evaluated for the subsequent risk of secondary lung cancer.

Download Full-text

CMET-42. USE OF STEREOTACTIC RADIOSURGERY AND OUTCOMES FOLLOWING RADIOTHERAPY FOR BRAIN METASTASES IN PATIENTS WITH PRIMARY LUNG CANCER – AN AUSTRALIAN POPULATION-BASED STUDY

Neuro-Oncology ◽

10.1093/neuonc/noz175.243 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi60-vi61

Author(s):

Wee Loon Ong ◽

Morikatsu Wada ◽

Farshad Foroudi

Keyword(s):

Lung Cancer ◽

Brain Metastases ◽

Stereotactic Radiosurgery ◽

Cox Regression ◽

Primary Lung Cancer ◽

Population Based ◽

Mortality Data ◽

Factors Associated ◽

Geographical Variations ◽

The Impact

Abstract INTRODUCTION We aim to evaluate the use of stereotactic radiosurgery (SRS) among lung cancer (LC) patients who received radiotherapy (RT) for brain metastases (BM), and the associated outcomes. METHODS This is a population-based cohort of LC patients who received RT for BM between 2013 and 2016, as captured in the Victorian Radiotherapy Minimum Dataset. Brain RT was classified as SRS (including multi-fraction stereotactic RT) and non-SRS. Mortality data was captured through data linkage with the Victorian Cancer Registry (VCR). The primary outcomes were: proportion of patients who had SRS for BM, and overall survival (OS) following brain RT. Multivariable logistic regression was used to evaluate factors associated with SRS use. Kaplan-Meier method was used to estimate OS. Multivariable Cox regression was used to evaluate factors associated with OS. RESULTS 1,002 LC patients were included in the study. 1,395 courses of RT for BM were delivered, of which one quarter (362/1,395) were SRS. Almost all SRS were delivered in metropolitan centres (347/362), and two-third in public institutions (235/362). In multivariate logistic regressions, increasing age (OR=0.91;95%CI=0.82–0.99;P=0.04) and treatment in regional centres (OR=0.13;95%CI=0.06–0.28;P< 0.001) were independently associated with lower likelihood of SRS use. Median follow-up was 3.3 months (IQR=1.3–7.8 months). 876 deaths were observed with 12-month OS of 16%. The 12-month OS for patients who had SRS were 38% vs. 12% in patient did not have SRS (P< 0.001). In multivariable Cox regressions, the use of SRS (HR=0.44,95%CI=0.37–0.54;P< 0.001) and female (HR=0.76;95%CI=0.67–0.87;P< 0.001) were associated with improved OS, while increasing age was associated with worse OS (HR=1.02;95%CI=1.01–1.03;P< 0.001). CONCLUSION This is the largest Australian study reporting on SRS use for BM in LC patients. We observed geographical variations in SRS use. We believe the impact of SRS use on OS is most likely due to patient selection for SRS.

Download Full-text

Incidence and real-world burden of brain metastases from solid tumors and hematologic malignancies in Ontario: a population-based study

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa178 ◽

2020 ◽

Author(s):

Steven Habbous ◽

Katharina Forster ◽

Gail Darling ◽

Katarzyna Jerzak ◽

Claire M B Holloway ◽

...

Keyword(s):

Lung Cancer ◽

Brain Metastases ◽

Real World ◽

Cancer Registries ◽

Cranial Irradiation ◽

Population Based ◽

System Level ◽

Administrative Databases ◽

Primary Cancer ◽

Breast Cancers

Abstract Background Although intracranial metastatic disease (IMD) is a frequent complication of cancer, most cancer registries do not capture these cases. Consequently, a data-gap exists, which thwarts system-level quality improvement efforts. The purpose of this investigation was to determine the real-world burden of IMD. Patients and methods Patients diagnosed with a non-central nervous system cancer between 2010 and 2018 were identified from the Ontario Cancer Registry. IMD was identified by scanning hospital administrative databases for cranial irradiation or coding for a secondary brain malignancy (ICD-10 code C793). Results 25,478 of 601,678 (4.2%) patients with a diagnosis of primary cancer were found to have IMD. The median time from primary cancer diagnosis to IMD was 5.2 (0.7, 15.4) months and varied across disease sites, e.g. 2.1 months for lung, 7.3 months for kidney, 22.8 months for breast). Median survival following diagnosis with IMD was 3.7 months. Lung cancer accounted for 60% of all brain metastases, followed by breast cancer (11%) and melanoma (6%). More advanced stage at diagnosis and younger age were associated with a higher likelihood of developing IMD (p<0.0001). IMD was also associated with triple-negative breast cancers and ductal histology (p<0.001), and with small-cell histology in patients with lung cancer (p<0.0001). The annual incidence of IMD was 3,520, translating to 24.2 per 100,000 persons. Conclusion IMD represents a significant burden in patients with systemic cancers and is a significant cause of cancer mortality. Our findings support measures to actively capture incidents of brain metastasis in cancer registries.

Download Full-text

Socio-economic disparities in non-small-cell lung cancer with brain metastases at presentation: a population-based study

World Neurosurgery ◽

10.1016/j.wneu.2021.07.024 ◽

2021 ◽

Author(s):

Ignacio Jusue-Torres ◽

Alicia Hulbert ◽

Jehad Zakaria ◽

Kathy S. Albain ◽

Courtney L. Hentz ◽

...

Keyword(s):

Lung Cancer ◽

Brain Metastases ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Population Based ◽

Small Cell ◽

Small Cell Lung ◽

Population Based Study ◽

Economic Disparities

Download Full-text

Familial colorectal cancer risk by subsite of primary cancer: a population-based study in Utah

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.13086 ◽

2015 ◽

Vol 41 (6) ◽

pp. 573-580 ◽

Cited By ~ 8

Author(s):

N. J. Samadder ◽

K. R. Smith ◽

G. P. Mineau ◽

R. Pimentel ◽

J. Wong ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Population Based ◽

Colorectal Cancer Risk ◽

Primary Cancer ◽

Familial Colorectal Cancer ◽

Population Based Study

Download Full-text

Survival of patients with synchronous brain metastases: an epidemiological study in southeastern Michigan

Neurosurgical FOCUS ◽

10.3171/foc.2000.9.2.2 ◽

2000 ◽

Vol 9 (2) ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Ajith J. Thomas ◽

Jack P. Rock ◽

Christine C. Johnson ◽

Linda Weiss ◽

Gordon Jacobsen ◽

...

Keyword(s):

Brain Metastases ◽

Median Survival ◽

Cancer Diagnosis ◽

Systemic Disease ◽

Primary Source ◽

Primary Site ◽

Unknown Primary ◽

Primary Cancer ◽

Significant Difference ◽

Frequent Site

Object It has been suggested that synchronous brain metastases (that is, those occurring within 2 months of primary cancer diagnosis) are associated with a shorter survival time compared with metachronous lesions (those occurring greater than 2 months after primary cancer diagnosis). In this study the authors used data obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program to determine the incidence of synchronous brain metastases and length of survival of patients in a defined population of southeastern Michigan residents. Methods Data obtained in 2682 patients with synchronous brain metastases treated from 1973 to 1995 were reviewed. Study criteria included patients in whom at least one brain metastasis was diagnosed within 2 months of the diagnosis of primary cancer and those with an unknown primary source. The incidence per 100,000 increased fivefold, from 0.69 in 1973 to 3.83 in 1995. The most frequent site for the primary cancer was the lung (75.4%). The second largest group (10.7%) consisted of patients in whom the primary site was unknown. The median survival length was 3.3 months. There was no significant difference in the median survival in patients with primary lung/bronchus and those with an unknown primary site (3.2 months and 3.4 months, respectively). Conclusions Patients who present with synchronous lesions have a poor prognosis, and the predominant cause of death, in greater than 90% of cases, is related to systemic disease; however, despite poor median survival lengths, certain patients will experience prolonged survival.

Download Full-text