Introduction: Metastatic brain cancer is the most common intracranial tumor in adults. It is ten times more common than any type of primary brain tumor. The most common origin of brain metastasis is lung cancer. The aim of this study is to determine the incidence and survival of patients with brain metastases at diagnosis of primary lung cancer and any covariates associated with increased incidence or decreased survival.
Methods: Data Acquisition: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database4 from 18 population-based central cancer registries from the US population, patients with brain metastasis at the time of lung cancer diagnosis from 2010-2014 were identified. ICD-O-3 codes used were: lung/bronchus and stratified by age, gender, lung cancer subtype, and race/origin, marital status, insurance.
Software: Surveillance Research Program, National Cancer Institute SEER*Stat software (www.seer.cancer.gov/seerstat) version 8.3.5.
Results: Using the search criteria, there were 240,251 patients diagnosed with lung cancer from 2010-2014 in the SEER database. Of these, 11.6% had brain metastases at diagnosis. Higher incidences were reported in patients that were male, married, or uninsured. Additionally, patients of black, hispanic, or asian origin/race had higher incidences as well as patients with primary lung cancers of small cells, large cell, or adenocarcinoma subtype. Overall survival was 5.0 months, with males, unmarried, and squamous subtype having lower survival.
Conclusions: For patients with brain metastases at the time of lung cancer diagnosis, population-based estimates of incidence and survival suggest certain demographics are associated with higher incidence of brain metastases and lower survival.
Patient Care: The findings in this study provide large-scale population-based estimates of incidence and survival of patients with concurrent brain metastases at diagnoses of primary lung cancer that can be utilized in clinical practice in regards to screening, follow-up, and exploring potential healthcare disparities.
Learning Objectives: By the conclusion fo this session, participants should be able to 1) Describe the importance of a population-based study in the incidence and survival of brain metastases, 2) Discuss certain demographics that have significantly different incidence and survival and 3) Identify potential future studies to evaluate and address health care disparities among patients with brain metastases at diagnosis of primary lung cancer.
References: Eichler AF, Loeffler JS: Multidisciplinary management of brain metastases. Oncologist 12:884-898, 2007.
Ewend MG, Morris DE, Carey LA, Ladha AM, Brem S: Guidelines for the initial management of metastatic brain tumors: role of surgery, radiosurgery, and radiation therapy. J Natl Compr Canc Netw 6:505-513; quiz 514, 2008.
Obenauf AC, Massague J: Surviving at a distance: organ specific metastasis. Trends Cancer. 2015 September 1; 1(1): 76–91. doi:10.1016/j.trecan. 2015.07.009.
Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research