P11.01.B THE IMPACT OF SURGICAL RESECTION OF SMALL CELL LUNG CARCINOMA BRAIN METASTASES ON OVERALL SURVIVAL

Abstract BACKGROUND Small Cell Lung Cancer (SCLC), accounting for 15% of lung cancers, is highly prone to brain metastases, occurring in up to 70% of patients at diagnosis. Brain metastases are associated with a poor prognosis, with median survival dropping to 5 months. Whole-brain radiotherapy (WBRT) was the standard treatment, but in the past decade, local treatment with stereotactic radiosurgery (SRS) has become more common, sparing patients the side effects of WBRT. Surgical resection has not been considered relevant, even for solitary or oligo brain metastases. MATERIAL AND METHODS This retrospective cohort study evaluates the impact of surgical resection on overall survival in SCLC patients with brain metastases, compared to radiotherapy (RT). Data was collected from patients treated at a single neurosurgery department between 2011 and 2025. Key variables included demographics, Karnofsky Performance Status (KPS), tumor characteristics, and survival outcomes. RESULTS Of 226 patients diagnosed with SCLC, 79 developed brain metastases. Fifteen patients underwent surgical resection followed by RT (surgical group) and 64 received only RT. The analysis included patients with up to 3 lesions, totaling 26 in the RT group. The mean age in the surgical and RT groups was 60.5±9.33 and 64.7±6.32, respectively (p>0.05). The mean KPS was 82.3±10.78 and 70.8±16.26, respectively (p>0.05). Median overall survival was 25.0 months (95% CI: 7.81-42.19) for the surgical group, compared to 5.97 months (95% CI: 1.64-10.29) for the RT group (p<0.05). CONCLUSIONS Surgical resection followed by RT in SCLC patients with brain metastases is associated with significantly improved survival compared to RT alone. Surgery may be an effective treatment option for patients with solitary or oligo brain metastases. Further studies with larger cohorts and long-term follow-up are needed to define patient selection for surgery.