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Brain metastasis from non-small cell lung cancer: management and prognosis of primary lung tumor resection

  • Donghang Li
  • Hongfeng Tong
  • Yaoguang Sun
  • Qingjun Wu
  • Chao Ma
  • Wenxin Tian
  • Chuan Huang
  • Hanbo Yu
  • Yi Tian
  • Peng Jiao

Abstract

Brain metastases (BM) will develop in 30-50% of non-small cell lung cancer (NSCLC) patients in the course of their illness. Systemic treatment is recommended for most advanced-stage NSCLC patients with BM but the prognosis remains poor. The prognosis and management of primary lung tumor resection are still a debated topic in this complex clinical setting. The present study will gather and review related research evidence. The survival benefit, patient selection and proper surgical strategy of primary lung tumor resection will be summarized and discussed in the treatment for NSCLC patients with BM.

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References

  1. Achrol A S, Rennert R C, Anders C, et al. Brain metastases[J]. Nat Rev Dis Primers, 2019,5(1):5.
  2. Goncalves P H, Peterson S L, Vigneau F D, et al. Risk of brain metastases in patients with nonmet-astatic lung cancer: Analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data[J]. Cancer, 2016,122(12):1921-1927.
  3. Proescholdt M A, Schodel P, Doenitz C, et al. The Management of Brain Metastases-Systematic Review of Neurosurgical Aspects[J]. Cancers (Basel), 2021,13(7).
  4. Jasper K, Stiles B, McDonald F, et al. Practical Management of Oligometastatic Non-Small-Cell Lung Cancer[J]. J Clin Oncol, 2022,40(6):635-641.
  5. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classifica-tion for Lung Cancer[J]. Journal of Thoracic Oncology, 2016,11(1):39-51.
  6. Zhang C, Ma N, Zhang Q, et al. Evaluation of local aggressive lung therapy versus systemic thera-py in oligometastatic non-small cell lung cancer: a systematic review and meta-analysis[J]. J Thorac Dis, 2021,13(10):5899-5910.
  7. Chen X R, Hou X, Li D L, et al. Management of Non-Small-Cell Lung Cancer Patients Initially Di-agnosed With 1 to 3 Synchronous Brain-Only Metastases: A Retrospective Study[J]. Clin Lung Can-cer, 2021,22(1):e25-e34.
  8. Enders F, Geisenberger C, Jungk C, et al. Prognostic factors and long-term survival in surgically treated brain metastases from non-small cell lung cancer[J]. Clinical Neurology and Neurosurgery, 2016,142:72-80.
  9. Gui Q, Liu J, Li D, et al. Prolonged survival of patients with EGFR-mutated non-small cell lung cancer with solitary brain metastases treated with surgical resection of brain and lung lesions followed by EGFR TKIs[J]. World J Surg Oncol, 2017,15(1):184.
  10. Mitchell K G, Farooqi A, Ludmir E B, et al. Pulmonary resection is associated with long-term survival and should remain a therapeutic option in oligometastatic lung cancer[J]. J Thorac Cardio-vasc Surg, 2021,161(4):1497-1504.
  11. Bai H, Xu J, Yang H, et al. Survival prognostic factors for patients with synchronous brain oli-gometastatic non-small-cell lung carcinoma receiving local therapy[J]. Onco Targets Ther, 2016,9:4207-4213.
  12. Yuksel C, Bozkurt M, Yenigun B M, et al. The outcome of bifocal surgical resection in non-small cell lung cancer with synchronous brain metastases: results of a single center retrospective study[J]. Thorac Cardiovasc Surg, 2014,62(7):605-611.
  13. Jones G D, Lengel H B, Hsu M, et al. Management of Synchronous Extrathoracic Oligometastatic Non-Small Cell Lung Cancer[J]. Cancers (Basel), 2021,13(8).
  14. Kumar A, Kumar S, Potter A L, et al. Surgical management of non-small cell lung cancer with limited metastatic disease involving only the brain[J]. J Thorac Cardiovasc Surg, 2023.
  15. Wang Q, Li J, Liang X, et al. Improved Survival With Surgical Treatment of Primary Lung Lesions in Non-Small Cell Lung Cancer With Brain Metastases: A Propensity-Matched Analysis of Surveil-lance, Epidemiology, and End Results Database[J]. Front Oncol, 2022,12:888999.
  16. Jia J, Guo B, Yang Z, et al. Outcomes of local thoracic surgery in patients with stage IV non-small-cell lung cancer: A SEER-based analysis[J]. Eur J Cancer, 2021,144:326-340.
  17. Hellman S, Weichselbaum R R. Oligometastases[J]. J Clin Oncol, 1995,13(1):8-10.
  18. She C, Wang R, Lu C, et al. Prognostic factors and outcome of surgically treated patients with brain metastases of non-small cell lung cancer[J]. Thorac Cancer, 2019,10(2):137-142.
  19. Wang Z, Gao S G, Xue Q, et al. Surgery of primary non-small cell lung cancer with oligometasta-sis: analysis of 172 cases[J]. J Thorac Dis, 2018,10(12):6540-6546.
  20. Li D, Zhu X, Wang H, et al. Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis[J]. Journal of thoracic dis-ease, 2017,9(2):310-317.
  21. Kanou T, Okami J, Tokunaga T, et al. Prognosis associated with surgery for non-small cell lung cancer and synchronous brain metastasis[J]. Surg Today, 2014,44(7):1321-1327.
  22. Girard N, Cottin V, Tronc F, et al. Chemotherapy is the cornerstone of the combined surgical treatment of lung cancer with synchronous brain metastases[J]. Lung Cancer, 2006,53(1):51-58.
  23. Billing P S, Miller D L, Allen M S, et al. Surgical treatment of primary lung cancer with synchro-nous brain metastases[J]. The Journal of Thoracic and Cardiovascular Surgery, 2001,122(3):548-553.
  24. Congedo M T, Nachira D, Bertolaccini L, et al. Multimodal therapy for synchronous bone oli-gometastatic NSCLC: The role of surgery[J]. J Surg Oncol, 2022,125(4):782-789.
  25. Liang H, Liu Z, Huang J, et al. Identifying optimal candidates for primary tumor resection among metastatic non-small cell lung cancer patients: a population-based predictive model[J]. Transl Lung Cancer Res, 2021,10(1):279-291.
  26. Spaggiari L, Bertolaccini L, Facciolo F, et al. A risk stratification scheme for synchronous oli-gometastatic non-small cell lung cancer developed by a multicentre analysis[J]. Lung Cancer, 2021,154:29-35.
  27. Opitz I, Patella M, Payrard L, et al. Prognostic factors of oligometastatic non-small-cell lung can-cer following radical therapy: a multicentre analysis[J]. Eur J Cardiothorac Surg, 2020,57(6):1166-1172.
  28. Isbell J M, Li B T, Gomez D R. The emerging role of local therapy in oligometastatic non-small cell lung cancer[J]. J Thorac Cardiovasc Surg, 2022,163(3):819-825.
  29. Eichhorn F, Winter H. How to handle oligometastatic disease in nonsmall cell lung cancer[J]. Eur Respir Rev, 2021,30(159).
  30. De Ruysscher D, Wanders R, Hendriks L E, et al. Progression-Free Survival and Overall Survival Beyond 5 Years of NSCLC Patients With Synchronous Oligometastases Treated in a Prospective Phase II Trial (NCT 01282450)[J]. J Thorac Oncol, 2018,13(12):1958-1961.
  31. Iyengar P, Wardak Z, Gerber D E, et al. Consolidative Radiotherapy for Limited Metastatic Non-Small-Cell Lung Cancer: A Phase 2 Randomized Clinical Trial[J]. JAMA Oncol, 2018,4(1):e173501.
  32. Gomez D R, Blumenschein G J, Lee J J, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progres-sion after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study[J]. Lancet Oncol, 2016,17(12):1672-1682.
  33. Rios-Hoyo A, Arriola E. Immunotherapy and brain metastasis in lung cancer: connecting bench side science to the clinic[J]. Front Immunol, 2023,14:1221097.
  34. Hao Z, Liang H, Zhang Y, et al. Surgery for advanced-stage non-small cell lung cancer: lobecto-my or sub-lobar resection?[J]. Transl Lung Cancer Res, 2021,10(3):1408-1423.
  35. Mitchell K G, Farooqi A, Ludmir E B, et al. Improved Overall Survival With Comprehensive Lo-cal Consolidative Therapy in Synchronous Oligometastatic Non-Small-Cell Lung Cancer[J]. Clin Lung Cancer, 2020,21(1):37-46.
  36. Gray P J, Mak R H, Yeap B Y, et al. Aggressive therapy for patients with non-small cell lung car-cinoma and synchronous brain-only oligometastatic disease is associated with long-term survival[J]. Lung Cancer, 2014,85(2):239-244.
  37. Parikh R B, Cronin A M, Kozono D E, et al. Definitive Primary Therapy in Patients Presenting With Oligometastatic Non-Small Cell Lung Cancer[J]. International Journal of Radiation Oncolo-gy*Biology*Physics, 2014,89(4):880-887.
  38. Xu Q, Wang Y, Liu H, et al. Treatment outcome for patients with primary NSCLC and synchro-nous solitary metastasis[J]. Clin Transl Oncol, 2013,15(10):802-809.
  39. Louie A V, Rodrigues G, Yaremko B, et al. Management and Prognosis in Synchronous Solitary Resected Brain Metastasis from Non–Small-Cell Lung Cancer[J]. Clinical Lung Cancer, 2009,10(3):174-179.
  40. Flannery T W, Suntharalingam M, Regine W F, et al. Long-term survival in patients with syn-chronous, solitary brain metastasis from non-small-cell lung cancer treated with radiosurgery[J]. Int J Radiat Oncol Biol Phys, 2008,72(1):19-23.
  41. Zhang Y, Zhang Y, Cheng X, et al. The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non-Small Cell Lung Cancer: A Population-Based Study[J]. Front On-col, 2022,12:853257.
  42. Antonoff M B, Feldman H A, Mitchell K G, et al. Surgical Complexity of Pulmonary Resections Performed for Oligometastatic NSCLC[J]. JTO Clin Res Rep, 2022,3(3):100288.
  43. Thomas A, Giaccone G. Why has active immunotherapy not worked in lung cancer?[J]. Annals of oncology, 2015,26(11):2213-2220.
  44. Ohtaki Y, Shimizu K, Suzuki H, et al. Salvage surgery for non-small cell lung cancer after tyrosine kinase inhibitor treatment[J]. Lung Cancer, 2021,153:108-116.
  45. Yoo S, Cho W C, Lee G D, et al. Long-term Surgical Outcomes in Oligometastatic Non-small Cell Lung Cancer: A Single-Center Study[J]. J Chest Surg, 2023,56(1):25-32.
  46. Sponholz S, Koch A, Mese M, et al. Lung Cancer Resection after Immunochemotherapy Versus Chemotherapy in Oligometastatic Nonsmall Cell Lung Cancer[J]. Thorac Cardiovasc Surg, 2023,71(8):656-663.
  47. Chen Y, Wang Y, Yang Z, et al. Local consolidative therapy for synchronous oligometastatic non-small cell lung cancer treated with first-line pembrolizumab: A retrospective observational study[J]. Thorac Cancer, 2022,13(5):732-741.
  48. Smith A, Wali A, Montes A, et al. Salvage pulmonary resection in stages IIIb-IV lung cancer after treatment with immune checkpoint inhibitors case series and literature review[J]. J Surg Oncol, 2022,125(2):290-298.

How to Cite

Li, Donghang, et al. “Brain Metastasis from Non-Small Cell Lung Cancer: Management and Prognosis of Primary Lung Tumor Resection ”. Human Brain, vol. 2, no. 4, Dec. 2023, doi:10.37819/hb.4.1794.

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DOI: https://doi.org/10.37819/hb.4.1794

Published: 2023-12-10

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Copyright (c) 2023 Donghang Li, Hongfeng Tong, Yaoguang Sun, Qingjun Wu, Chao Ma, Wenxin Tian, Chuan Huang, Hanbo Yu, Yi Tian, Peng Jiao

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