Combined treatment of non-small cell lung cancer with synchronous brain metastases

A single center experience

G. Melloni, A. Bandiera, V. Gregorc, A. Carretta, P. Ciriaco, M. G. Viganò, A. Franzin, A. Bolognesi, P. Picozzi, P. Zannini

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Aim. The aim of this study was to analyze our experience with combined treatment of non-small cell lung cancer with synchronous brain metastases. Methods. Between 1992 and 2008, 31 patients were treated by performing neurosurgery (or stereotactic radiosurgery) and lung surgery. Patients were divided into two groups according to their preoperative mediastinal work-up: group A (CT scan) and group B (FDG-PET scan). Results. Twenty-six patients had one brain metastasis and five had two. Neurosurgery was performed in 10 patients, stereotactic radiosurgery in 20 and both approaches in 1. Seven patients underwent chemotherapy after cerebral procedure. Pulmonary resection was complete in 27 cases and incomplete in 4. Histological findings showed: adenocarcinoma in 19 cases, squamous cell carcinoma in 8 and large cell carcinoma in 4. All patients underwent adjuvant chemotherapy. Overall 1, 2 and 5-year survival rates were 83%, 47% and 21%, respectively. The median survival was 22 months. Univariate analysis showed a better prognosis for complete resection (P=0.008), adenocarcinomas (P=0.015), N0 disease (P=0.038), and Group B (P=0.045). Multivariate analysis showed that only the radicality of the resection (P=0.027) and Group B (P=0.047) were independent prognostic factors. Conclusion. Our experience confirms that selected patients with non-small cell lung cancer and synchronous brain metastases may be effectively treated by combined therapy. Complete resection, adenocarcinoma histology and NO disease were prognostic factors. The incorporation of FDG-PET scan into the preoperative work-up may translate into a survival benefit.

Original languageEnglish
Pages (from-to)613-619
Number of pages7
JournalJournal of Cardiovascular Surgery
Volume52
Issue number4
Publication statusPublished - Aug 2011

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Non-Small Cell Lung Carcinoma
Neoplasm Metastasis
Brain
Adenocarcinoma
Radiosurgery
Neurosurgery
Positron-Emission Tomography
Therapeutics
Large Cell Carcinoma
Lung
Survival
Adjuvant Chemotherapy
Brain Neoplasms
Squamous Cell Carcinoma
Histology
Multivariate Analysis
Survival Rate
Drug Therapy

Keywords

  • Brain diseases
  • Carcinoma, non-small-cell lung
  • General surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Melloni, G., Bandiera, A., Gregorc, V., Carretta, A., Ciriaco, P., Viganò, M. G., ... Zannini, P. (2011). Combined treatment of non-small cell lung cancer with synchronous brain metastases: A single center experience. Journal of Cardiovascular Surgery, 52(4), 613-619.

Combined treatment of non-small cell lung cancer with synchronous brain metastases : A single center experience. / Melloni, G.; Bandiera, A.; Gregorc, V.; Carretta, A.; Ciriaco, P.; Viganò, M. G.; Franzin, A.; Bolognesi, A.; Picozzi, P.; Zannini, P.

In: Journal of Cardiovascular Surgery, Vol. 52, No. 4, 08.2011, p. 613-619.

Research output: Contribution to journalArticle

Melloni, G, Bandiera, A, Gregorc, V, Carretta, A, Ciriaco, P, Viganò, MG, Franzin, A, Bolognesi, A, Picozzi, P & Zannini, P 2011, 'Combined treatment of non-small cell lung cancer with synchronous brain metastases: A single center experience', Journal of Cardiovascular Surgery, vol. 52, no. 4, pp. 613-619.
Melloni G, Bandiera A, Gregorc V, Carretta A, Ciriaco P, Viganò MG et al. Combined treatment of non-small cell lung cancer with synchronous brain metastases: A single center experience. Journal of Cardiovascular Surgery. 2011 Aug;52(4):613-619.
Melloni, G. ; Bandiera, A. ; Gregorc, V. ; Carretta, A. ; Ciriaco, P. ; Viganò, M. G. ; Franzin, A. ; Bolognesi, A. ; Picozzi, P. ; Zannini, P. / Combined treatment of non-small cell lung cancer with synchronous brain metastases : A single center experience. In: Journal of Cardiovascular Surgery. 2011 ; Vol. 52, No. 4. pp. 613-619.
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AU - Gregorc, V.

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AU - Ciriaco, P.

AU - Viganò, M. G.

AU - Franzin, A.

AU - Bolognesi, A.

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N2 - Aim. The aim of this study was to analyze our experience with combined treatment of non-small cell lung cancer with synchronous brain metastases. Methods. Between 1992 and 2008, 31 patients were treated by performing neurosurgery (or stereotactic radiosurgery) and lung surgery. Patients were divided into two groups according to their preoperative mediastinal work-up: group A (CT scan) and group B (FDG-PET scan). Results. Twenty-six patients had one brain metastasis and five had two. Neurosurgery was performed in 10 patients, stereotactic radiosurgery in 20 and both approaches in 1. Seven patients underwent chemotherapy after cerebral procedure. Pulmonary resection was complete in 27 cases and incomplete in 4. Histological findings showed: adenocarcinoma in 19 cases, squamous cell carcinoma in 8 and large cell carcinoma in 4. All patients underwent adjuvant chemotherapy. Overall 1, 2 and 5-year survival rates were 83%, 47% and 21%, respectively. The median survival was 22 months. Univariate analysis showed a better prognosis for complete resection (P=0.008), adenocarcinomas (P=0.015), N0 disease (P=0.038), and Group B (P=0.045). Multivariate analysis showed that only the radicality of the resection (P=0.027) and Group B (P=0.047) were independent prognostic factors. Conclusion. Our experience confirms that selected patients with non-small cell lung cancer and synchronous brain metastases may be effectively treated by combined therapy. Complete resection, adenocarcinoma histology and NO disease were prognostic factors. The incorporation of FDG-PET scan into the preoperative work-up may translate into a survival benefit.

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