Survival Analysis And Prognostic Factors Of Patients After Resection Of Brain Metastases From Lung Carcinoma

Objective:The purpose of this study is to analyze the long-term survival of patients with brain metastases from lung carcinoma after surgical resection of brain metastases,to explore the factors that affect prognosis,and to provide reference for further diagnosis and treatment of patients with brain metastases from lung carcinoma after surgery.Methods:A total of 35 patients who underwent craniotomy for brain metastases from lung carcinoma for the purpose of resection of intracranial lesions in Shanxi provincial people’s Hospital from January 2011 to August 2021 were included in this study.The histopathological diagnosis was lung carcinoma with brain metastases.Personal data and clinical data were retrospectively analyzed,and the following clinically relevant data were collected: age,gender,number of brain metastases,presence or absence of extracranial metastases,continued postoperative cranial therapy,whether primary lung carcinoma was treated or not,Brain metastases pathological types,immunohistochemical indicators Ki-67、Thyroid Transcription Factor 1(TTF-1),etc.The study used SPSS(26.0)software for statistical analysis,and the Kaplan-Meier method was used to draw the survival curve to describe the survival situation.The included factors were analyzed by univariate,and the Log-rank method was used to test whether the influence of each factor on survival was statistically significant.(P<0.05),Variables with statistically significant differences in univariate analysis were included in COX proportional hazards model to identify independent factors affecting prognosis(P<0.05).Results:1.Survival status: The follow-upended on Match 1,2022.Among the 35 patients,10(28.6%)were alive and 25(71.4%)died.There were no significant differences in baseline characteristics(age,gender)between the survival group and the death group.The shortest survival time of patients was 0 months,the longest was 52 months,and the median survival time was 14.0 ± 5.2 months.The 1-year,2-year,3-year,and 4-year cumulative survival rates after brain metastases resection were: 49.2%,24.7%,12.4%、2.9%,and the 5-year cumulative survival rate was 0.2.Univariate analysis: In the study,the prognostic factors of patients after resection of lung metastases from lung carcinoma included the continuous treatment after craniocerebral surgery(P < 0.003),the treatment of primary lung carcinoma(P<0.001),and the pathological type of brain metastases(P<0.001).3.COX multivariate analysis: The pathological type of brain metastases(HR=2.605,95% Cl:1.102-6.157)and the follow-up treatment of primary lung carcinoma(HR=0.121,95% Cl:0.025-0.597)were independent prognostic factors.Conclusion:The survival time of patients with brain metastasis of lung carcinoma is short,the pathological type is non-small cell lung carcinoma(NSCLC),and the survival time of patients with further treatment of brain and lung after operation is relatively longer.the pathological type and follow-up treatment of primary lung carcinoma are independent prognostic factors.