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Identification of a high-risk group for brain metastases in non-small cell lung cancer patients

Abstract

Purpose

Identification of a high-risk group of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) could lead to early interventions and probably better prognosis. The objective of the study was to identify this group by generating a multivariable model with recognized and accessible risk factors.

Methods

A retrospective cohort from patients seen at a single center during 2010–2020, was divided into a training (TD) and validation (VD) datasets, associations with BM were measured in the TD with logit, variables significantly associated were used to generate a multivariate model. Model´s performance was measured with the AUC/C-statistic, Akaike information criterion, and Brier score.

Results

From 570 patients with NSCLC who met the strict eligibility criteria a TD and VD were randomly assembled, no significant differences were found amid both datasets. Variables associated with BM in the multivariate logit analyses were age [P 0.001, OR 0.96 (95% CI 0.93–0.98)]; mutational status positive [P 0.027, OR 1.96 (95% CI 1.07–3.56); and carcinoembryonic antigen levels [P 0.016, OR 1.001 (95% CI 1.000–1.003). BM were diagnosed in 24% of the whole cohort. Stratification into a high-risk group after simplification of the model, displayed a frequency of BM of 63% (P < 0.001).

Conclusion

A multivariate model comprising age, carcinoembryonic antigen levels, and mutation status allowed the identification of a truly high-risk group of BM in NSCLC patients.

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Data availability

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Funding

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Authors

Contributions

CRediT statements for each author. Conceptualization: BC, OA. Methodology, Formal analysis: BC, NR. Data acquisition: LDC, JAR. Writing—Original Draft: BC, YJG. Writing—Review & Editing: OA.

Corresponding authors

Correspondence to Bernardo Cacho-Díaz or Oscar Arrieta.

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Conflict of interest

None. The authors have no financial or proprietary interests in any material discussed in this article.

Ethical approval

The retrospective nature of the study avoids any exposure to the patients; therefore, an informed consent was not required. Approval registration number CI/0676/2021.

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Cacho-Díaz, B., Cuapaténcatl, L.D., Rodríguez, J.A. et al. Identification of a high-risk group for brain metastases in non-small cell lung cancer patients. J Neurooncol 155, 101–106 (2021). https://doi.org/10.1007/s11060-021-03849-w

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Keywords

  • Brain metastases
  • Lung cancer
  • Predictive model
  • Neuro-oncology
  • Non-small cell lung cancer