A combined surgical approach to non-oat-cell pulmonary carcinoma with single cerebral metastasis

• Published in: Respiration Vol. 51; no. 3; p. 170
• Main Authors: Rossi, N P, Zavala, D C, VanGilder, J C
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.1987
• Subjects: Brain Neoplasms - mortality; Brain Neoplasms - secondary; Brain Neoplasms - surgery; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - surgery; Combined Modality Therapy; Female; Humans; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Middle Aged
• ISSN: 0025-7931
• DOI: 10.1159/000195199

Eighty consecutive patients with pulmonary non-oat-cell carcinoma and a single cerebral metastasis were followed for at least 5 years after therapy. Forty were treated by surgical excision at both sites of disease plus whole-brain irradiation in most cases (group 1). The remaining 40 patients, an observational cohort, were treated either by surgery at only one site of disease (usually craniotomy), whole-brain irradiation, chemotherapy, or some combination of these modalities (group 2). The 1-year survival in group 2 was 15%, and all were dead at 2 years. In group 1, hospital mortality was 1.5%, the 1-year survival rate 35%, the 2-year survival rate 25%, and the 5-year survival rate 12.5%. All the five year survivors were patients with N0 disease. In this subgroup of group 1, the five year survival was 20%. All patients surviving for more than 2 years were in group 1 and had a Karnofsky rating greater than 50 and N0 disease after staging. These data indicate that a combined surgical approach can be accomplished with low morbidity, low mortality, and increased survival rates, especially for patients with N0 disease who are vigorous enough to undergo the combined treatment.