The Surgical Management of Brain Metastases in Non-Small Cell Lung Cancer (NSCLC): Identification of the Early Laboratory and Clinical Determinants of Survival

Author:

Schneider MatthiasORCID,Schäfer Niklas,Bode ChristianORCID,Eichhorn LarsORCID,Giordano Frank A.,Güresir ErdemORCID,Heimann Muriel,Ko Yon-Dschun,Landsberg Jennifer,Lehmann FelixORCID,Radbruch Alexander,Schaub Christina,Schwab Katjana S.,Weller Johannes,Herrlinger Ulrich,Vatter Hartmut,Schuss PatrickORCID

Abstract

Background: Brain metastases (BM) indicate advanced states of cancer disease and cranial surgery represents a common treatment modality. In the present study, we aimed to identify the risk factors for a reduced survival in patients receiving a surgical treatment of BM derived from non-small cell lung cancer (NSCLC). Methods: A total of 154 patients with NSCLC that had been surgically treated for BM at the authors’ institution between 2013 and 2018 were included for a further analysis. A multivariate analysis was performed to identify the predictors of a poor overall survival (OS). Results: The median overall survival (mOS) was 11 months (95% CI 8.2–13.8). An age > 65 years, the infratentorial location of BM, elevated preoperative C-reactive protein levels, a perioperative red blood cell transfusion, postoperative prolonged mechanical ventilation (>48 h) and the occurrence of postoperative adverse events were identified as independent factors of a poor OS. Conclusions: The present study identified several predictors for a worsened OS in patients that underwent surgery for BM of NSCLC. These findings might guide a better risk/benefit assessment in the course of metastatic NSCLC therapy and might help to more sufficiently cope with the challenges of cancer therapy in these advanced stages of disease.

Publisher

MDPI AG

Subject

General Medicine

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