Risk of development of brain metastases according to the IASLC/ATS/ERS lung adenocarcinoma classification in locally advanced and metastatic disease

Introduction: Brain metastases (BM) are frequent among lung cancer patients, affecting prognosis and quality of life. The International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS) and European Respiratory Society (ERS) lung adenocarcinoma (LADC) classification (...

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Autores:
Arrieta, Oscar
Avilés Salas, Alejandro
Cardona, Andrés Felipe
Díaz-García, Diego
Lara-Mejía, Luis
Escamilla, Ixel
Pereira García, Ariana
Caballé Pérez, Enrique
Estuardo Raez, Luis
Rolfo, Christian Diego
Costa Rosell, Rafael
Tipo de recurso:
Article of journal
Fecha de publicación:
2021
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/5572
Acceso en línea:
http://hdl.handle.net/20.500.12495/5572
https://doi.org/10.1016/j.lungcan.2021.01.023
Palabra clave:
Central nervous system metastases
Histologic grade
Adenocarcinoma subtype
Differentiation grade
Lung cancer
Rights
openAccess
License
Acceso abierto
Description
Summary:Introduction: Brain metastases (BM) are frequent among lung cancer patients, affecting prognosis and quality of life. The International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS) and European Respiratory Society (ERS) lung adenocarcinoma (LADC) classification (IASLC/ATS/ERS) has prog-nostic impact in early-stage disease; however, its role in the advanced setting is not precise. This study aims to determine the correlation between the predominant histological subtype and the risk of developing brain me-tastases (BM) in locally advanced and metastatic (stages IIIB-IV) LADC. Methods: A total of 710 patients with LADC were treated at our institution from January 2010 to December 2017. After excluding patients with brain metastases at diagnoses (n =151), they were categorized according to the IASLC/ATS/ERS LADC classification to estimate the risk of developing brain metastases. A competing risk analysis was employed, considering death a competing risk event. Results: From 559 patients, the mean age was 59 ±13.2 years, women (52.4 %), and clinical-stage IV (79.2 %). LADC subtypes distribution was lepidic (11.6 %), acinar (37.9 %), papillary (10.2 %), micropapillary (6.8 %), and solid (33.5 %). A total of 27.0 % of patients developed BM, 32.9 % died without brain affection, and 40.0 % did not progress. The predominantly solid subtype showed the greatest probability of all subtypes for developing BM [HR 4.0; 95 % CI (1.80