Prognostic Factors in Postoperative Brain Metastases Derive From Non-small Cell Lung Cancer: A Retrospective Analysis.

Abstract

Background: Brain metastases are crucial in cancer progression, requiring focused efforts on the screening, early detection, and treatment. However, accurate forecasting the postoperative prognosis of patients with non-small cell lung cancer brain metastasis remains a challenge. This retrospective study aims to discern the factors that influence the prognosis of such patients.

Methods: A total of 151 cases from Zhejiang Cancer Hospital were collected. Univariate analysis was conducted using Kaplan-Meier and Log-rank test, while multivariate analysis was performed using Cox proportional hazards regression model. Student's t-test and chi-square test were employed to examine the differences between the long-term survival and the short-term survival groups. Ultimately, a predictive model was constructed using R 4.2.1.

Results: Univariate analysis identified 12 factors as prognostic factors, showing statistical significance. In multivariate analysis, the primary contributing factors to survival were identified as age, chemotherapy of brain metastases, pathology, surgery of nonsmall cell lung cancer, targeted drugs, and GPA score. Comparing long-term and short-term groups, age, pathology, surgery of lung, targeted therapy, and radiotherapy of brain metastases were statistically differentiating factors. Based on multivariate analysis, we established a clinical predictive model predicting 2-year, 3-year, and 5-year survival rates.

Conclusion: Younger age, receiving chemotherapy for brain metastases, adenocarcinoma pathology, lung cancer surgery, targeted therapy, and a high GPA score are associated with longer survival. This model predicts the survival period for patients with non-small cell lung cancer brain metastasis after surgery and helps in selecting more effective treatment plans.