Outcomes of Non-Small-Cell Lung Cancer Resection in Patients With Synchronous Brain Metastases.

Area of Science:

• Thoracic Surgery
• Neurosurgery
• Oncology

Background:

• Lung cancer frequently metastasizes to the brain.
• Synchronous brain metastases pose treatment challenges.
• Integrated treatment strategies are crucial for improving outcomes.

Purpose of the Study:

• To evaluate the outcomes of combined lung tumor resection and radical brain metastasis treatment.
• To identify factors influencing survival in patients with synchronous brain metastases.

Main Methods:

• Retrospective analysis of 86 patients undergoing lung tumor resection and brain metastasis treatment (2005-2024).
• Prioritization of local treatment for brain metastases (neurosurgery, Gamma Knife, radiotherapy).
• Analysis of lung surgery types and systemic therapy timing.

Main Results:

• 5-year overall survival was 43.4% and disease-free survival was 32.9%.
• Factors associated with improved survival included younger age, better ECOG performance status, preserved FEV1, and receipt of systemic therapy.
• Prioritizing local treatment for brain metastases was associated with poorer outcomes.

Conclusions:

• Curative-intent treatment for lung cancer with oligometastatic brain involvement is feasible and can lead to significant long-term survival.
• Patient selection is key, favoring younger, fitter individuals with good pulmonary function.
• Multidisciplinary approaches integrating surgery and systemic therapy are essential.