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Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer.

Publication ,  Journal Article
Hubbs, JL; Boyd, JA; Hollis, D; Chino, JP; Saynak, M; Kelsey, CR
Published in: Cancer
November 1, 2010

BACKGROUND: The risk of developing brain metastases after definitive treatment of locally advanced nonsmall cell lung cancer (NSCLC) is approximately 30%-50%. The risk for patients with early stage disease is less defined. The authors sought to investigate this further and to study potential risk factors. METHODS: The records of all patients who underwent surgery for T1-T2 N0-N1 NSCLC at Duke University between the years 1995 and 2005 were reviewed. The cumulative incidence of brain metastases and distant metastases was estimated by using the Kaplan-Meier method. A multivariate analysis assessed factors associated with the development of brain metastases. RESULTS: Of 975 consecutive patients, 85% were stage I, and 15% were stage II. Adjuvant chemotherapy was given to 7%. The 5-year actuarial risk of developing brain metastases and distant metastases was 10%(95% confidence interval [CI], 8-13) and 34%(95% CI, 30-39), respectively. Of patients developing brain metastases, the brain was the sole site of failure in 43%. On multivariate analysis, younger age (hazard ratio [HR], 1.03 per year), larger tumor size (HR, 1.26 per cm), lymphovascular space invasion (HR, 1.87), and hilar lymph node involvement (HR, 1.18) were associated with an increased risk of developing brain metastases. CONCLUSIONS: In this large series of patients treated surgically for early stage NSCLC, the 5-year actuarial risk of developing brain metastases was 10%. A better understanding of predictive factors and biological susceptibility is needed to identify the subset of patients with early stage NSCLC who are at particularly high risk.

Duke Scholars

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

November 1, 2010

Volume

116

Issue

21

Start / End Page

5038 / 5046

Location

United States

Related Subject Headings

  • Risk Factors
  • Recurrence
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hubbs, J. L., Boyd, J. A., Hollis, D., Chino, J. P., Saynak, M., & Kelsey, C. R. (2010). Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer. Cancer, 116(21), 5038–5046. https://doi.org/10.1002/cncr.25254
Hubbs, Jessica L., Jessamy A. Boyd, Donna Hollis, Junzo P. Chino, Mert Saynak, and Chris R. Kelsey. “Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer.Cancer 116, no. 21 (November 1, 2010): 5038–46. https://doi.org/10.1002/cncr.25254.
Hubbs JL, Boyd JA, Hollis D, Chino JP, Saynak M, Kelsey CR. Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer. Cancer. 2010 Nov 1;116(21):5038–46.
Hubbs, Jessica L., et al. “Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer.Cancer, vol. 116, no. 21, Nov. 2010, pp. 5038–46. Pubmed, doi:10.1002/cncr.25254.
Hubbs JL, Boyd JA, Hollis D, Chino JP, Saynak M, Kelsey CR. Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer. Cancer. 2010 Nov 1;116(21):5038–5046.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

November 1, 2010

Volume

116

Issue

21

Start / End Page

5038 / 5046

Location

United States

Related Subject Headings

  • Risk Factors
  • Recurrence
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Follow-Up Studies
  • Female