RT Book, Section A1 Krasna, Mark J. A2 Sugarbaker, David J. A2 Bueno, Raphael A2 Colson, Yolonda L. A2 Jaklitsch, Michael T. A2 Krasna, Mark J. A2 Mentzer, Steven J. A2 Williams, Marcia A2 Adams, Ann SR Print(0) ID 1105842705 T1 Resection of Bronchogenic Carcinoma with Oligometastatic Disease T2 Adult Chest Surgery, 2e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-178189-3 LK accesssurgery.mhmedical.com/content.aspx?aid=1105842705 RD 2024/11/08 AB The development of brain metastasis in a patient with non–small-cell lung cancer (NSCLC) is an ominous prognostic sign. About 30% of individuals with NSCLC eventually develop brain metastasis.1 This number increases to about 50% in autopsy series.2 When the metastases are multiple, palliative treatment in the form of radiation therapy is recommended. Solitary brain metastasis, however, can be approached surgically. The proportion of NSCLC patients that develops brain metastasis amounts to approximately 40,000 patients per year. The magnitude of this problem can be appreciated by comparing this number with the incidence of new primary cancers of the pancreas (n = 27,000), stomach (n = 24,000), and esophagus (n = 13,000). The median survival rate of untreated lung cancer with brain metastasis is approximately 1 month. Steroid therapy increases the median survival by 2 months. Whole-brain radiation increases survival by 3 to 6 months.3 Recent reports indicate longer survivals when surgical treatment is combined with whole-brain radiation.4,5 The experience of several large centers that offer a surgical approach to lung cancer with brain metastasis is discussed herein, with an analysis of factors underlying prolonged survival.