Predictors of Prognosis of Surgically Resected Brain Metastasis from Lung Cancer with a Focus on Brain Recurrence

Abstract Purpose: There are many considerations to decide surgical treatment in lung cancer-brain metastasis. Herein, we analyzed survival and predictors of brain recurrence after surgical resection of brain metastasis from lung cancer. Methods: A total of 224 metastatic brain tumors from patients with lung cancer were analyzed. Results: There were 138 (61.6%) male and 86 (38.4%) female patients; 197 patients with non-small cell lung cancer (NSCLC) and 27 with small cell lung cancer (SCLC). The rate of postoperative complications was 4.9%. The 1-year and 2-year overall survival (OS) was 57% and 43%, respectively. The 6-month and 1-year progression-free survival (PFS) of local recurrence was 42% and 20%, respectively. In NSCLC and SCLC groups, the difference of PFS of local recurrence according to adjuvant resection bed irradiation was not significant (1-year: 20% vs. 22%, p=0.8) and (1-year: 14% vs. 25%, p=0.16), respectively. Whole-brain irradiation did not show a significant difference of distant recurrence (6-month: 54% vs. 60%, p=0.13). In predictor analysis, female sex was a favorable prognostic factor for OS, while SCLC histology and postoperative neurological deficits were poor prognostic factors in univariate analysis. Conclusions: SCLC histology and postoperative complications are negative predictors for OS. Adjuvant irradiation did not show effectiveness to reduce local and distant recurrence.