ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Results of surgical resection in lung cancer with synchronous brain metastasis
Volkan Baysungur1, Çagatay Tezel1, Hakan Kıral1, Bora Gürer2, Serda Metin Kanbur1, Levent Alpay1, Talha Doğruyol3, Deniz Gürer1, Hakan Yılmaz1
1Department of Thoracic Surgery, Süreyyapaşa Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Neurosurgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
3Department of Thoracic Surgery, Tunceli State Hospital, Tunceli, Turkey
DOI : 10.5606/tgkdc.dergisi.2019.15427
Background: This study aims to investigate the factors affecting the survival of operated non-small cell lung cancer patients with synchronous brain metastasis.

Methods: Clinical outcomes of a total of 16 patients (14 males, 2 females; mean age 60 years; range, 41 to 71 years) who were diagnosed with non-small cell lung cancer and concomitant solitary/oligo brain metastasis and who underwent an intervention primarily for cranium, followed by lung resection in our clinic between January 2012 and January 2016 were retrospectively analyzed. Cranial surgery or gamma-knife radiosurgery was performed in the treatment of brain metastases.

Results: Twelve patients with solitary brain metastasis underwent cranial surgery, while four patients with solitary/oligo metastases underwent gamma-knife radiosurgery prior to pulmonary resection. Definitive pathological examination revealed adenocarcinoma in 13 patients and squamous-cell lung carcinoma in three patients. Mean survival time was 15.3±8.6 months. One-year and two-year survival rates were 56.2% and 32%, respectively. The number of brain metastases, treatment type, tumor cell type, resection type, and status of lymph nodes were not statistically significantly associated with survival (p>0.05).

Conclusion: Cranial surgery or gamma-knife radiosurgery followed by aggressive lung resection can be effectively applied in selected non-small cell lung cancer patients with synchronous brain metastasis. However, the suitability of the primary tumor and brain metastases for complete resection is of utmost importance in patient selection.

Keywords : Lung cancer; oligometastasis; synchronous brain metastasis
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