Met-4 analysis of metastatic brain tumors discovered at the same time as the primary lesion

Abstract Introduction Among metastatic brain tumors, especially in cases where the primary tumor and metastatic brain tumor are found at the same time, it is necessary to consider the priority of treatment for intracranial lesions and the means to obtain a definitive diagnosis. In this study, we performed a statistical analysis on the factors affecting mean survival (mOS) in patients with concurrent primary and metastatic brain tumors. Subjects and Methods A total of 252 patients with metastatic brain tumors treated at our hospital since 2014 were divided into two groups: simul-meta (58 patients) and non-simul-meta (194 patients). Age, sex, primary tumor, number of tumors, presence or absence of metastasis to other organs, localization of intracranial lesions, presence or absence of carcinomatous meningitis, performance status (PS), details of therapeutic intervention (radiation therapy, chemotherapy, surgery). The background factors between the two groups were analyzed using the chi-square test. Factors affecting mOS were evaluated by univariate analysis with log-rank test and multivariate analysis with Cox proportional hazards test. Results In simul-meta and non-simul-meta, mOS was 328 and 295 days, respectively (p=0.864). As a background, lung cancer (76%: 59%; p = 0.02) and surgical intervention group (28%: 11%; p <0.01) were numerous in simul-meta. Good prognostic factors in the simul-meta group extracted by multivariate analysis were surgical intervention and cases of chemotherapy. Chemotherapy cases were stratified into conventional chemotherapy and molecular-targeted drug use, and the prognosis of molecular-targeted cases was better than that of conventional chemotherapy (p=0.01). Discussion In patients with concurrent disease, it is important to complete treatment for intracranial lesions, including surgical treatment, and maintain a general condition that allows chemotherapy to be administered. In addition, considering the frequent occurrence of lung cancer, it is necessary to develop a treatment plan with molecular target therapy in mind.