2013 Volume 27 Issue 7 Pages 788-793
Because of the low incidence of brain metastasis after complete resection of pathological stage I non-small cell lung cancer (NSCLC), periodic brain magnetic resonance imaging is not recommended for all patients. To establish criteria for the selection of patients who should undergo strict screening for brain metastasis, we performed a retrospective review of 218 patients with pathological stage I NSCLC who underwent surgery at our hospital between January 1999 and December 2008. The brain was the initial site of recurrence in 8 patients, and these patients were compared with 177 patients without brain metastasis. Thirty-three recurrence-free patients with a follow-up period of <4 years were excluded from this analysis. We observed that the risk of brain metastasis increased in patients with T1b or T2a disease, moderately or poorly differentiated non-squamous cell carcinoma, or undifferentiated carcinoma, and the right upper lobe was the site of origin. We noted a disease-free interval of >3 years in 2 patients. High-risk patients require careful long-term screening for brain metastasis.
