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Ann Thorac Surg 2005;79:241-247
© 2005 The Society of Thoracic Surgeons
a Departments of Medical Informatics, Pathology, and Surgery, University of Szeged, Szeged
b Department of Thoracic Surgery, National Korányi Institute for Pulmonology, Budapest
c Department of Surgery, Buda MÁV Hospital, Budapest, Hungary
d Department of Medical Informatics, University of Szeged, Szeged, Hungary
e Department of Pathology, University of Szeged, Szeged, Hungary
Accepted for publication June 7, 2004.
* Address reprint requests to Dr Furak, 20 Thokoly St, H-6726, Szeged, Hungary (E-mail: jfurak{at}hotmail.com).
Presented at the Fortieth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 26–28, 2004.
BACKGROUND: We assessed the survival rates regarding different stages of operable lung cancers causing operable brain metastasis in patients with or without cancer-related symptoms. The correlation between survival rates and the disease-free interval between lung surgery and metastasectomy was studied.
METHODS: Sixty-five patients were operated on for lung cancer and brain metastases. The disease-free interval was divided into 5 subgroups: 0–2 months, 3–5 months, 6–11 months, 12–23 months, and 24 months and beyond. The study group comprised of patients with lung cancer in the following stages: 17 patients in stage I (1 patient in stage IA, 16 patients in stage IB), 16 patients in stage II (2 patients in stage IIA, 14 patients in stage IIB), 9 patients in stage IIIA, 4 patients in stage IIIB, and 19 patients in stage IV. Forty-four patients were symptom-free for lung cancer and 21 patients manifested lung cancer related symptoms.
RESULTS: The 5-year survival rates were as follows: stage I = 22%, stage II = 20%, stage IIIA = 22%, stage IIIB = 0%, and stage IV = 23% after lung resections. There were no significant differences in the 5-year survival rates regarding the disease-free interval subgroups after brain metastasectomies (p = 0.19): disease-free interval 0–2 months = 22% and disease-free interval 24 months and beyond = 23%. The 5-year survival rate after metastasectomy was significantly greater (26% vs 5%) in patients without lung cancer related symptoms (p = 0.05).
CONCLUSIONS: The 5-year survival rate in stage I, II, IIIA, and IV lung cancer with operable hematogenous brain metastases corresponds to that in the customary stage IIIA (23%). The disease-free interval exhibited no significant impact on the survival rate. The complaint-free status exhibits a significantly greater impact on the survival rate in hematogenic metastasis.
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