Brain metastases in non-small cell lung cancer: Prevalence, high-risk factors, and overall survival prognosis

Abstract Introduction This study assesses brain metastases (BM) in non-small cell lung cancer (NSCLC) – its prevalence, risk factors, overall survival, and influencing aspects. Materials and methods A retrospective observational study was conducted at Nghe An Oncology Hospital in Vietnam. We assessed 895 patients diagnosed with NSCLC between June 2019 and June 2023. We used univariate and multivariate logistic regression models to assess the association of BM with factors. We evaluated the overall survival (OS) time using the Kaplan–Meier method and assessed differences using the log-rank test. In addition, we determined the association between OS time and factors using the Cox regression model. Results The prevalence of BM in NSCLC at the time of diagnosis was 13.1%. BM were associated with non-squamous carcinoma (odds ratio [OR] = 2.04, 95% confidence interval [95% CI]: 1.01–4.14), lymph node stage N3 (OR = 1.77, 95% CI: 1.15–2.72), and serum carcinoembryonic antigen (CEA) ≥5 ng/ml (OR = 1.81, 95% CI: 1.05–3.13). The median OS time for patients with BM was lower than in those without BM (15.3 vs. 18.3 months, p = 0.005). When analyzing multivariable Cox regression, the OS time of patients with BM was associated with positive EGFR/ALK gene mutation status (hazard ratio [HR] = 0.38, 95% CI: 0.20–0.70) and number of brain metastatic in 1–3 lesions (HR = 0.56, 95% CI: 0.33–0.96). Conclusions The prevalence of BM at the time of diagnosis in NSCLC was 13.1% and was associated with non-squamous carcinoma, node stage, and serum CEA. EGFR/ALK gene mutation status and the number of brain metastatic lesions were independent prognostic factors for OS of BM NSCLC.