| Institution: | 1. Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;2. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;3. Department of Thoracic Surgery and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea |
| Abstract: | BackgroundStudies have shown that 30–50% of non-small cell lung cancer (NSCLC) patients develop brain metastasis (BM). Since BM shortens overall survival and decreases the quality of life, early detection and treatment of BM are vital. While data are available for clinical risk factors of NSCLC with BM, histopathological factors are not well understood. Therefore, we evaluated the histopathological related factors which will help early detection and selection of effective treatment options.Materials and methodsA total of 117 surgical lung specimens diagnosed as NSCLC with BM were included as a study group. We included 237 cases without BM as a control group. One pathologist reviewed H&E slides and analyzed the histopathologic factors of all cases.ResultsIn pulmonary adenocarcinoma, vascular invasion, N stage, micropapillary pattern and necrosis were significantly associated with BM in multivariate analysis (vascular invasion, p?=?0.009; micropapillary pattern, p?=?0.024; others, p?<?0.001). Tumor with extensive necrosis had higher hazard ratio and shorter time to BM (p?<?0.001).ConclusionOur findings suggest that necrosis is a new predictive factor of BM in pulmonary adenocarcinoma. Short term follow-up is needed especially when extensive necrosis is present. |
