Dandan  Zhou,Haijun Zhang,Hongming  Zhang,Wenwen  Xu,
Effect of Cerebral Infarction on the Risk of Synchronous Brain Metastasis: Analysis of 307 Consecutive Patients of Newly Diagnosed Non-Small Cell Lung Cancer
Clinical Oncology and Research
2020
2613-4942
http://dx.doi.org/10.31487/j.COR.2020.05.07
https://www.sciencerepository.org/effect-of-cerebral-infarction-on-the-risk-of-synchronous-brain-metastasis_COR-2020-5-107 
Abstract: Background: Brain metastasis (BM) is a common complication of patients with non-small cell lung cancer
(NSCLC) and associated with a poor prognosis. The study aimed to evaluate the effect of cerebral infarction
(CI) on the risk of BM in NSCLC for preventive therapy strategy.
Methods: 307 patients with newly diagnosed NSCLC in Zhongda Hospital, Medical School of Southeast
University from July 2013 to July 2018 were retrospectively analyzed. Depending on magnetic resonance
imaging (MRI), the patients were divided into the BM group and the control group (without BM). Then, the
prevalence of CI and baseline clinicopathological parameters were evaluated and compared between the
two groups.
Results: Out of the 307 patients, 204 patients (66.4%) had CI, and 52 patients (16.9%) had BM. Especially,
the prevalence of CI in the NSCLC patients with BM was 84.6%, which was significantly higher than that
of 62.7% in the NSCLC patients without BM (p = 0.002). Following univariate logistic regression analysis
and the multivariate model, the results demonstrated that CI was a significant independent risk factor for
BM in NSCLC (odds rate [OR], 2.921; 95% confidence interval [CI], 1.242-6.873; p = 0.014). Moreover,
CI contributed to a worse prognosis in NSCLC patients with BM. Finally, dynamical trace confirmed CI
could promote BM in NSCLC patients.
Conclusions: CI could be associated with a metastatic tropism to the brain and then with an increased risk
of BM in NSCLC patients. Therefore, the targeted intervention of the metastatic niche of CI could offer a
promising approach for the prevention, prognostic evaluation, and therapy of BM in NSCLC patients for
better clinical outcomes.Keywords: Metastatic niche, non-small cell lung cancer, brain metastasis, cerebral infarction