Title: Factors contributing to the occurrence of cancer metastasis to brain

Authors: T.N.Vijayasree, Vidhya Narasimhan, R. Mohan Kumar, M.Mohamed Ibrahim

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.153

Abstract

In a cancer patient when there is metastasis to brain the prognosis becomes very poor. But only some patients get metastasis to brain. In this study, in patients with brain metastasis, the demographic profile, the site of primary tumour, stage at diagnosis, histopathology, immunohistochemistry and extent of dissemination, have been analysed to throw light on susceptibility to metastasis brain. 35 patients with brain metastasis treated in a period of 5 years were studied retrospectively. 40% of the patients were young (age group 31- 45 years) and 50 % presented with only headache. There was strong association between occurrence of multiple metastasis brain (against single lesion brain) and visceral /bone spread. Breast was the most common primary site in the whole group while lung was commoner in exclusive brain metastasis subset and patients in stage four at initial presentation itself. This signifies the need for screening for lung malignancy in the high risk group to detect at an earlier stage. Lung cancer patients have 4 times more chance of having brain metastasis with no visceral or bone metastasis. In breast cancer 17% patients have exclusive brain metastasis. In 2 patients PET CT detected asymptomatic metastatic lesions brain.

Keywords: Metastasis brain, Secondaries brain.

References

  1. Nayak, L., Lee, E.Q. & Wen, P.Y. Curr Oncol Rep (2012) 14: 48. https://doi.org/10.1007/s11912-011-0203-y
  2. Barnholtz-Sloan, J. S., Sloan, A. E., Davis, F. G., Vigneau, F. D., Lai, P., & Sawaya, R. E. (2004). Incidence Proportions of Brain Metastases in Patients Diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. Journal of clinical oncology, 22(14), 2865-2872. doi: 10.1200/jco.2004.12.149
  3. Seoanea, Joan and De Mattos-Arrudaa, Leticia, (2014), Brain metastasis: New opportunities to tackle therapeutic resistance, Molecular Oncology, 8, doi: 10.1016/j.molonc.2014.05.009.
  4. Pérez-Larraya JG, Hildebrand J. Brain metastases. In Handbook of Clinical Neurology 2014 Jan 1 (Vol. 121, pp. 1143-1157). Elsevier. https://doi.org/ 10.1016/B978-0-7020-4088-7.00077-8
  5. Saha, A., Ghosh, S. K., Roy, C., Choudhury, K. B., Chakrabarty, B., & Sarkar, R. (2013). Demographic and clinical profile of patients with brain metastases: A retrospective study. Asian journal of neurosurgery, 8(3), 157–161. doi:10.4103/1793-5482.121688.
  6. Fabi A, Felici A, Metro G, Mirri A, Bria E, Telera S, Moscetti L, Russillo M, Lanzetta G, Mansueto G, Pace A. Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center. Journal of Experimental & Clinical Cancer Research. 2011 Dec;30(1):10.
  7. Singh S, Amirtham U, Premalata CS, Lakshmaiah KC, Viswanath L, Kumar RV. Spectrum of metastatic neoplasms of the brain: A clinicopathological study in a tertiary care cancer centre. Neurol India [serial online] 2018 [cited 2019 Jul 19];66:733-8. Available from: http:// www.neurologyindia.com/ text.asp?2018/66/3/ 733/ 232333
  8. Bochev P, Klisarova A, Kaprelyan A, Chaushev B, Dancheva Z. Brain metastases detectability of routine whole body (18)F-FDG PET and low dose CT scanning in 2502 asymptomatic patients with solid extracranial tumors. Hell J Nucl Med. 2012 May-Aug;15(2) 125-129. doi:10.1967/s002449910030. PMID: 22741148.
  9. Nussbaum, E. S., Djalilian, H. R., Cho, K. H. and Hall, W. A. (1996), Brain metastases: Histology, multiplicity, surgery, and survival. Cancer, 78: 1781-1788. doi:1002/(SICI)1097-0142(19961015)78:8<1781::AID-CNCR19>3.0.CO;2-U.
  10. Daniel N Cagney, Allison M Martin, Paul J Catalano, Amanda J Redig, Nancy U Lin, Eudocia Q Lee, Patrick Y Wen, Ian F Dunn, Wenya Linda Bi, Stephanie E Weiss, Daphne A Haas-Kogan, Brian M Alexander, Ayal A Aizer, Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study, Neuro-Oncology, Volume 19, Issue 11, November 2017, Pages 1511–1521, https://doi.org/10.1093/neuonc/nox077

Corresponding Author

Vidhya Narasimhan

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