Brain Metastases of Non–Small Cell Lung Cancer: Prognostic Factors in Patients with Surgical Resection

Background and Study Aims  Bronchogenic carcinoma is the cancer that most commonly metastasizes to the brain. The standard treatment schedule for these patients is still unclear, although recommendation level 1 class I advocates for surgical resection together with postoperative whole-brain radiotherapy for patients with good Karnofsky performance status (KPS). We performed a study to identify prognostic factors for the long-term survival of patients with brain metastases from non–small cell lung cancer (NSCLC). Patients  This retrospective single-center study included 71 patients with brain metastases from NSCLC having undergone surgical metastasectomy between January 2002 and January 2015. Results  The average age was 58.8 years. A total of 85.9% of the lesions were located in the supratentorial region, 61.9% of the lesions were   70 in 74.6% of patients, and the postoperative KPS was > 70 in 85.9% of patients. Overall, 84.5% of the brain surgeries had no complications. Brain metastases were diagnosed as a synchronous presentation in 64.7% of patients. The average survival after brain surgery was 20.38 months. The survival rate was 66.2% at 6 months, 45.1% at 12 months, 22.5% at 24 months, 14.1% at 36 months, and 8.5% at 48 months. Patients   70 years of age showed a higher mortality rate at 6 months. Complete surgical brain metastasis resection was associated with an increased survival at 6 months, and patients undergoing primary lung surgery had better survival rates at 48 months. A preoperative KPS > 70% improved the prognosis of patients at 6 and 24 months. Surgical complications reduced survival at 6 and 12 months. Conclusion  Surgical resection may be beneficial for a given group of patients: a preoperative KPS > 70; age