Clinicopathologic and genomic features associated with brain metastasis after resection of lung adenocarcinoma Journal Article
| Authors: | Dunne, E. G.; Fick, C. N.; Mastrogiacomo, B.; Tan, K. S.; Toumbacaris, N.; Vanstraelen, S.; Rocco, G.; Chaft, J. E.; Iyengar, P.; Gomez, D.; Adusumilli, P. S.; Park, B. J.; Isbell, J. M.; Bott, M. J.; Sihag, S.; Molena, D.; Huang, J.; Jones, D. R. |
| Article Title: | Clinicopathologic and genomic features associated with brain metastasis after resection of lung adenocarcinoma |
| Title Series: | JTCVS Open |
| Abstract: | Objective: To identify clinicopathologic and genomic features associated with brain metastasis after resection of lung adenocarcinoma (LUAD) and to evaluate survival after brain metastasis. Methods: Patients who underwent complete resection of stage I-IIIA LUAD between 2011 and 2020 were included. A subset of patients had broad-based panel next-generation sequencing performed on their tumors. Fine-Gray models for the development of brain metastasis were constructed, with death without brain metastasis as a competing risk. Results: A total of 2660 patients were included. The median duration of follow-up was 71 months (95% confidence interval [CI], 69-73 months). The cumulative incidence of brain metastasis at 10 years was 9.8%. Among patients who developed a brain metastasis, the median time from surgery to brain metastasis was 21 months (interquartile range, 10-42 months). Higher maximum standardized uptake value of the primary tumor, neoadjuvant therapy, lymphovascular invasion, and stage III disease were associated with the development of brain metastasis. Among patients who underwent next-generation sequencing, a multivariable analysis identified neoadjuvant therapy, pathologic stage, and TP53 mutations as associated with development of brain metastasis. The median survival after brain metastasis was 18 months (95% CI, 13-24 months). Better performance status, lack of extracranial metastasis, stereotactic radiosurgery, and targeted therapy were associated with better survival after brain metastasis. Conclusions: Brain metastasis is common after complete resection of LUAD and often occurs within 2 years. Markers of aggressive tumor biology, including higher maximum standardized uptake value, lymphovascular invasion, and TP53 mutations, and neoadjuvant therapy are associated with brain metastasis. © 2024 The Author(s) |
| Keywords: | neoadjuvant therapy; lung adenocarcinoma; brain metastasis; lymphovascular invasion |
| Journal Title: | JTCVS Open |
| Volume: | 22 |
| ISSN: | 2666-2736 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-12-01 |
| Start Page: | 458 |
| End Page: | 469 |
| Language: | English |
| DOI: | 10.1016/j.xjon.2024.09.030 |
| PROVIDER: | scopus |
| PMCID: | PMC11704575 |
| PUBMED: | 39780816 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is David R. Jones -- Source: Scopus |
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