Top

BMC Cancer

Published in:

Open Access 01-12-2021 | Lung Cancer | Research

The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database

Authors: Heng Shen, Gang Deng, Qianxue Chen, Jin Qian

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

The prognosis of lung cancer with synchronous brain metastasis (LCBM) is very poor, and patients often die within a short time. However, little is known about the early mortality and related factors in patients with LCBM.

Methods

Patients diagnosed with LCBM between 2010 and 2016 were enrolled from the Surveillance, Epidemiology, and End Result (SEER) database. Univariate and multivariate logistic regression analysis were used to identify significant independent prognostic factors, which were used to construct nomograms of overall and cancer-specific early death. Then, the prediction ability of the model was verified by receiver operating characteristic (ROC) curve. At last, the clinical application value of the model was tested through decision curve analysis (DCA).

Results

A total of 29,902 patients with LCBM were enrolled in this study. Among them, 13,275 (44.4%) patients had early death, and 11,425 (38.2%) cases died of lung cancer. The significant independent risk factors for overall and cancer-specific early death included age, race, gender, Gleason grade, histological type, T stage, N stage, bone metastasis, liver metastasis and marital status, which were used to construct the nomogram. The ROC curve demonstrated good predictive ability and clinical application value. The areas under the curve (AUC) of the training group was 0.793 (95% CI: 0.788–0.799) and 0.794 (95% CI: 0.788–0.799), in the model of overall and cancer-specific early death respectively. And the AUC of the validation group were 0.803 (95% CI: 0.788–0.818) and 0.806 (95% CI: 0.791–0.821), respectively. The calibration plots of the model showed that the predicted early death is consistent with the actual value. The DCA analysis indicated a good clinical application value of this model.

Conclusions

We established a comprehensive nomogram to predict early death in lung cancer patients with synchronous brain metastases. Nomograms may help oncologists develop better treatment strategies, such as clinical trials and hospice care.

Available only for authorised users

Sacks P, Rahman M. Epidemiology of brain metastases. Neurosurg Clin N Am. 2020;31(4):481–8. https://doi.org/10.1016/j.nec.2020.06.001.CrossRefPubMed

Kotecha R, Gondi V, Ahluwalia MS, Brastianos PK, Mehta MP. Recent advances in managing brain metastasis. F1000Res. 2018 Nov 9;7: F1000 Faculty Rev-1772. doi: https://doi.org/10.12688/f1000research.15903.1.

Davis FG, Dolecek TA, McCarthy BJ, Villano JL. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data. Neuro-Oncology. 2012;14(9):1171–7. https://doi.org/10.1093/neuonc/nos152.CrossRefPubMedPubMedCentral

Kromer C, Xu J, Ostrom QT, Gittleman H, Kruchko C, Sawaya R, et al. Estimating the annual frequency of synchronous brain metastasis in the United States 2010-2013: a population-based study. J Neuro-Oncol. 2017 Aug;134(1):55–64. https://doi.org/10.1007/s11060-017-2516-7.CrossRef

Cagney DN, Martin AM, Catalano PJ, Redig AJ, Lin NU, Lee EQ, et al. Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study. Neuro-Oncology. 2017 Oct 19;19(11):1511–21. https://doi.org/10.1093/neuonc/nox077.CrossRefPubMedPubMedCentral

Consonni D, Pierobon M, Gail MH, Rubagotti M, Rotunno M, Goldstein A, et al. Lung cancer prognosis before and after recurrence in a population-based setting. J Natl Cancer Inst. 2015;107(6):djv059. https://doi.org/10.1093/jnci/djv059.CrossRefPubMedPubMedCentral

Naylor EC, Desani JK, Chung PK. Targeted therapy and immunotherapy for lung Cancer. Surg Oncol Clin N Am. 2016;25(3):601–9. https://doi.org/10.1016/j.soc.2016.02.011.CrossRefPubMed

Janakiram M, Pareek V, Cheng H, Narasimhulu DM, Zang X. Immune checkpoint blockade in human cancer therapy: lung cancer and hematologic malignancies. Immunotherapy. 2016 Jun;8(7):809–19. https://doi.org/10.2217/imt-2016-0001.CrossRefPubMedPubMedCentral

Yong CSM, Dardalhon V, Devaud C, Taylor N, Darcy PK, Kershaw MH. CAR T-cell therapy of solid tumors. Immunol Cell Biol. 2017 Apr;95(4):356–63. https://doi.org/10.1038/icb.2016.128.CrossRefPubMed

10.

Tan WL, Jain A, Takano A, Newell EW, Iyer NG, Lim WT, et al. Novel therapeutic targets on the horizon for lung cancer. Lancet Oncol. 2016 Aug;17(8):e347–62. https://doi.org/10.1016/S1470-2045(16)30123-1.CrossRefPubMed

11.

Niranjan A, Lunsford LD, Ahluwalia MS. Targeted therapies for brain metastases. Prog Neurol Surg. 2019;34:125–37. https://doi.org/10.1159/000493057 Epub 2019 May 16.CrossRefPubMed

12.

Yamanaka R, Koga H, Yamamoto Y, Yamada S, Sano T, Fukushige T. Characteristics of patients with brain metastases from lung cancer in a palliative care center. Support Care Cancer. 2011 Apr;19(4):467–73. https://doi.org/10.1007/s00520-010-0838-5.CrossRefPubMed

13.

Qiu MZ, Shi SM, Chen ZH, Yu HE, Sheng H, Jin Y, et al. Frequency and clinicopathological features of metastasis to liver, lung, bone, and brain from gastric cancer: a SEER-based study. Cancer Med. 2018 Aug;7(8):3662–72. https://doi.org/10.1002/cam4.1661.CrossRefPubMedPubMedCentral

14.

Zhao Y, Xu G, Guo X, Ma W, Xu Y, Peltzer K, et al. Early Death Incidence and Prediction in Stage IV Breast Cancer. Med Sci Monit. 2020;26:e924858. https://doi.org/10.12659/MSM.924858.CrossRefPubMedPubMedCentral

15.

Wu J, Zhang H, Li L, Hu M, Chen L, Xu B, et al. A nomogram for predicting overall survival in patients with low-grade endometrial stromal sarcoma: a population-based analysis. Cancer Commun (Lond). 2020 Jul;40(7):301–12. https://doi.org/10.1002/cac2.12067.CrossRef

16.

Fitzgerald M, Saville BR, Lewis RJ. Decision curve analysis. JAMA. 2015;313(4):409–10. https://doi.org/10.1001/jama.2015.37.CrossRefPubMed

17.

Vickers AJ, Elkin EB. Decision curve analysis: a novel method for evaluating prediction models. Med Decis Making. 2006;26(6):565-574. 27. Camp RL, Dolled-F DOI: https://doi.org/10.1177/0272989X06295361.

18.

Schmidt-Hansen M, Berendse S, Hamilton W. Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review. Fam Pract. 2015;32(6):618–23. https://doi.org/10.1093/fampra/cmv075.CrossRefPubMedPubMedCentral

19.

Ascha MS, Ostrom QT, Wright J, Kumthekar P, Bordeaux JS, Sloan AE, et al. Lifetime occurrence of brain metastases arising from lung, breast, and skin cancers in the elderly: a SEER-Medicare study. Cancer Epidemiol Biomark Prev. 2019 May;28(5):917–25. https://doi.org/10.1158/1055-9965.EPI-18-1116.CrossRef

20.

Wang M, Wu Q, Zhang J, Qin G, Yang T, Liu Y, et al. Prognostic impacts of extracranial metastasis on non-small cell lung cancer with brain metastasis: a retrospective study based on surveillance, epidemiology, and end results database. Cancer Med. 2020;10(2):471–82. https://doi.org/10.1002/cam4.3562.CrossRefPubMedPubMedCentral

21.

Gu Y, Zhang J, Zhou Z, Liu D, Zhu H, Wen J, et al. Metastasis Patterns and Prognosis of Octogenarians with NSCLC: A Population-based Study. Aging Dis. 2020;11(1):82–92. https://doi.org/10.14336/AD.2019.0414.CrossRefPubMedPubMedCentral

22.

Yang J, Zhang Y, Sun X, Gusdon AM, Song N, Chen L, et al. The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: a SEER-based study. J Cancer Res Clin Oncol. 2018 Sep;144(9):1835–42. https://doi.org/10.1007/s00432-018-2702-9.CrossRefPubMed

23.

Goncalves PH, Peterson SL, Vigneau FD, Shore RD, Quarshie WO, Islam K, et al. Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the metropolitan Detroit surveillance, epidemiology, and end results (SEER) data. Cancer. 2016 Jun 15;122(12):1921–7. https://doi.org/10.1002/cncr.30000.CrossRefPubMed

24.

Song Z, Wang Y, Zhang D, Zhou Y. A novel tool to predict early death in uterine sarcoma patients: a surveillance, epidemiology, and end results-based study. Front Oncol. 2020;10:608548. https://doi.org/10.3389/fonc.2020.608548.CrossRefPubMedPubMedCentral

25.

Yang Y, Chen ZJ, Yan S. The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study. J Gastrointest Oncol. 2020;11(5):964–82. https://doi.org/10.21037/jgo-20-217.CrossRefPubMedPubMedCentral

Title: The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database
Authors: Heng Shen
Gang Deng
Qianxue Chen
Jin Qian
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Lung Cancer
Metastasis
Lung Cancer
Lung Cancer
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08490-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Immune checkpoint inhibitors plus neoadjuvant chemotherapy in early triple-negative breast cancer: a systematic review and meta-analysis

Lymphatic leakage after pelvic lymphadenectomy for cervical cancer: a retrospective case-control study

The small-molecule protein ligand interface stabiliser E7820 induces differential cell line specific responses of integrin α2 expression

Clinical significance of the cachexia index in patients with small cell lung cancer

Bevacizumab for radiation necrosis following radiotherapy of brain metastatic disease: a systematic review & meta-analysis

LncRNA WT1-AS downregulates lncRNA UCA1 to suppress non-small cell lung cancer and predicts poor survival

Keynote webinar | Spotlight on antibody–drug conjugates in cancer