The Prevalence and Predictors of Brain Metastases in Patients with T1N0 Non-Small-Cell Lung Cancer; A Contemporary Analysis of Current NCCN Guidelines
Presented During:
Sunday, May 4, 2025: 9:00AM - 4:00PM
Seattle Convention Center | Summit
Posted Room Name:
Poster Area, Exhibit Hall
Abstract No:
P0196
Submission Type:
Abstract Submission
Authors:
Catherine Williamson (1), Alexandra Potter (1), Soneesh Kothagundla (1), Camille Mathey-Andrews (1), Jane Yanagawa (2), Mongwei Lin (3), Michael Lanuti (4), Chi-Fu Yang (1)
Institutions:
(1) Massachusetts General Hospital, Boston, MA, (2) David Geffen School of Medicine at UCLA, Los Angeles, CA, (3) National Taiwan University, Taipei, NA, (4) Harvard University, Boston, MA
Submitting Author:
Catherine Williamson
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
Co-Author(s):
Alexandra Potter
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
Soneesh Kothagundla
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
Camille Mathey-Andrews
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
*Jane Yanagawa
-
Contact Me
David Geffen School of Medicine at UCLA
David Geffen School of Medicine at UCLA
Mongwei Lin
-
Contact Me
National Taiwan University
National Taiwan University
*Michael Lanuti
-
Contact Me
Harvard University
Harvard University
*Chi-Fu Yang
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
Presenting Author:
Catherine Williamson
-
Contact Me
Massachusetts General Hospital
Massachusetts General Hospital
Abstract:
Objective
Currently, U.S. national guidelines do not recommend routine screening for brain metastases with brain MRI for patients with T1N0 non-small-cell lung cancer (NSCLC). The objective of this study is to evaluate the prevalence and predictors of brain metastases in patients with T1 N0 NSCLC.
Methods
The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify adults with primary NSCLC between 2010-2019. Patients with concomitant cancer diagnoses and with missing variables were excluded from analysis. Patients were considered to have undergone pre-treatment brain MRI if the imaging occurred within two months of diagnosis. Outcomes of interest included the presence of, and factors correlated with having brain metastases. Multivariable logistic regression was utilized to adjust outcomes for age, sex, race, comorbid conditions, T-status and tumor histopathology, reported as adjusted odds ratios (aOR) with 95% confidence intervals.
Results
Of 37,737 adults with T1N0 disease included for analysis, 18,629 (49.4%) underwent a brain MRI at time of diagnosis and 1,690 (4.5%) were noted to have a brain metastasis. Those with brain metastases were younger (72.8 vs 74.0 years, p<0.001), more frequently male (46.6 vs 43.9%, p=0.03), more likely to identify as Black (8.2 vs 6.8%, p=0.01), and more likely to have any smoking history (88.8 vs 85.8%, p<0.001). Compared to those without brain metastases, this cohort was more frequently Stage T1c (53.8 vs 45.1%, p<0.001) and diagnosed with Adenocarcinoma (54.8 vs 44.1%, p<0.001) and Large Cell Carcinoma (2.2 vs 1.02%, p<0.001) rather than Squamous Cell Carcinoma (17.4 vs 22.6%, p<0.001). On multivariable-adjusted analysis, factors associated with increased likelihood of having brain metastases included younger age (aOR: 0.98 per year, 95% CI: 0.98-0.99, Figure), Black race (aOR: 1.15, 95% CI: 1.01-1.31, ref: White), smoking status (aOR: 1.33, 95% CI: 1.14-1.54). Stage T1c (aOR: 1.35, 95% CI: 1.11-1.65, ref: T1a, Figure), Adenocarcinoma (aOR: 1.76, 95% CI: 1.55-1.99) and Large Cell Carcinoma (aOR: 3.39, 95% CI: 1.83-3.61, ref: Squamous Cell Carcinoma).
Conclusions
In this national analysis of T1N0 NSCLC, the prevalence of brain metastases was 4.5%. In the setting of T1N0Mx NSCLC, evaluation with brain imaging may be considered in patients with high risk features, such as those with T1c Adenocarcinoma.
Currently, U.S. national guidelines do not recommend routine screening for brain metastases with brain MRI for patients with T1N0 non-small-cell lung cancer (NSCLC). The objective of this study is to evaluate the prevalence and predictors of brain metastases in patients with T1 N0 NSCLC.
Methods
The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify adults with primary NSCLC between 2010-2019. Patients with concomitant cancer diagnoses and with missing variables were excluded from analysis. Patients were considered to have undergone pre-treatment brain MRI if the imaging occurred within two months of diagnosis. Outcomes of interest included the presence of, and factors correlated with having brain metastases. Multivariable logistic regression was utilized to adjust outcomes for age, sex, race, comorbid conditions, T-status and tumor histopathology, reported as adjusted odds ratios (aOR) with 95% confidence intervals.
Results
Of 37,737 adults with T1N0 disease included for analysis, 18,629 (49.4%) underwent a brain MRI at time of diagnosis and 1,690 (4.5%) were noted to have a brain metastasis. Those with brain metastases were younger (72.8 vs 74.0 years, p<0.001), more frequently male (46.6 vs 43.9%, p=0.03), more likely to identify as Black (8.2 vs 6.8%, p=0.01), and more likely to have any smoking history (88.8 vs 85.8%, p<0.001). Compared to those without brain metastases, this cohort was more frequently Stage T1c (53.8 vs 45.1%, p<0.001) and diagnosed with Adenocarcinoma (54.8 vs 44.1%, p<0.001) and Large Cell Carcinoma (2.2 vs 1.02%, p<0.001) rather than Squamous Cell Carcinoma (17.4 vs 22.6%, p<0.001). On multivariable-adjusted analysis, factors associated with increased likelihood of having brain metastases included younger age (aOR: 0.98 per year, 95% CI: 0.98-0.99, Figure), Black race (aOR: 1.15, 95% CI: 1.01-1.31, ref: White), smoking status (aOR: 1.33, 95% CI: 1.14-1.54). Stage T1c (aOR: 1.35, 95% CI: 1.11-1.65, ref: T1a, Figure), Adenocarcinoma (aOR: 1.76, 95% CI: 1.55-1.99) and Large Cell Carcinoma (aOR: 3.39, 95% CI: 1.83-3.61, ref: Squamous Cell Carcinoma).
Conclusions
In this national analysis of T1N0 NSCLC, the prevalence of brain metastases was 4.5%. In the setting of T1N0Mx NSCLC, evaluation with brain imaging may be considered in patients with high risk features, such as those with T1c Adenocarcinoma.
THORACIC:
Lung Cancer
Image or Table
