Brain metastasis in resected lung cancer: Value of intensive follow-up with computed tomography

Background. Brain metastases are a common mode of recurrence in resected lung cancer and are usually associated with an ominous outcome. Methods. To assess the usefulness of follow-up using computed tomography of the brain for early detection and effective treatment of brain metastases, we prospectively studied 128 patients with completely resected non—small cell lung cancer. Follow-up computed tomographic scans were obtained every 2 to 6 months over 24 postoperative months in 69 patients and every 2 months for 6 postoperative months in 59. Results. Brain metastases were discovered in 11 patients (8.6%), and 7 patients were neurologically asymptomatic when the metastases were diagnosed. Single metastasis was found in 5 patients and multiple metastases in 6. The maximal size of all but one lesion was less than 25 mm. The median survival time and 5-year survival rate in all 11 patients with brain metastases were 10 months and 24%, respectively. Furthermore, those in 7 asymptomatic patients were 25 months and 38%, respectively. Conclusions. We consider intensive follow-up with computed tomography to be worthwhile for early detection and effective treatment of brain metastases in patients with completely resected lung cancer.