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The Incidence of Brain Metastasis at Initial Diagnosis of Lung Squamous Cell Carcinoma based on the Stages excluding Brain Metastasis
정숙현 , 이현 , 엄상원 , 정병호 , 이경종 , 정만표 , 권오정 , 김호중
UCI I410-ECN-0102-2016-510-000648460
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Introduction: Current Comprehensive Cancer Network(NCCN) guidelines recommend brain magnetic resonance imaging (MRI) screening in patients with non-small cell lung carcinoma with stage II to IV disease, regardless of histological subtype. However, brain metastasis is seen less frequently in patients with lung squamous cell carcinoma (SqCC) than in those with non-squamous histology. Furthermore, the coexistence of brain metastasis across TNM stage in lung ScCC have not been well documented. Methods: A retrospective review of 564 patients who were diagnosed of lung SqCC between Jan 2012 and Dec 2013 was performed for comprehensive staging. Brain metastasis was not included in the stratification of staging. Results: Of the 564 patients, 28 (5.0%) had brain metastases. Brain metastasis did not occur in patients with stage I disease. Brain metastasis occurred more frequently as the stage increased from stage II to IV disease (P<0.001, trend test). These trends were specifically associated with increasing N and M components (P<0.001, trend test for both), while no trend existed between brain metastasis and an increase of T component. Multivariate analysis showed that tumor involvement in N3 lymph nodes and distant metastasis other than brain was associated with the development of brain metastases in patients with SqCC. Conclusions: Routine brain MR screening in patients with lung SqCC with stage II to IV disease can help to evaluate asymptomatic brain metastasis. By contrast, we did not find any evidence to perform routine brain MRI screening in patients with stage I disease.

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