496P - Association of brain metastasis and peritumoral edema volume with the neurological symptom burden in lung cancer patients

Background

Given the diverse clinical presentation of brain metastases (BM) in non-small cell lung cancer (NSCLC), we aimed to investigate whether the neurological symptom burden correlates with the volume of the BM as well as the peritumoral edema in a real-world patient cohort.

Methods

Cranial magnetic resonance imaging at the time of BM diagnosis was retrospectively analyzed in patients with BM from NSCLC to determine the extent of BM volume and peritumoral edema volume. Volumes of BM and peritumoral edema were categorized into quartiles (class I-IV) for statistical analysis.

Results

312 patients with information on BM volume and peritumoral edema volume were included. The median BM volume was 2.78cm³ (range 0-82.4), while the median peritumoral edema volume was 25.6 cm³ (range 0-251). 248/312 (79.5%) patients presented with neurological symptoms at BM diagnosis. An increase of BM or peritumoral edema volume also showed an increased likelihood of neurological symptoms (BM volume: OR: 1.83; CI 1.43-2.43; p<0.001; edema volume: OR: 1.4; CI 1.25-1.58; p<0.001). In detail, a correlation between the presence of focal deficits with BM and edema volume (p<0.02), and a correlation between BM volume and signs of increased intracranial pressure (p=0.001) was found. In contrast, no statistically significant association was detected between epileptic seizures and BM or edema volume (p>0.05). Incorporating interaction terms into the analysis to investigate the correlation with sex, age, and localization of BM, we observed that the effect of BM or peritumoral edema volume remained consistent across these different levels (p>0.05). Both, peritumoral edema volume and BM volume, didn’t correlate with survival in univariate and multivariate models, while the presence of neurological symptoms at BM diagnosis (HR:1.46; CI 1.0-2.8, p=0.03) presented as independent prognostic factors.

Conclusions

In conclusion, larger volumes of BM or peritumoral edema correlated with an increased probability of neurological symptoms, but not with the occurrence of epileptic seizures. In contrast to neurological symptoms at BM diagnosis, BM volume and peritumoral edema volume were not associated with prognosis in our real-world patient cohort.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Preusser: Financial Interests, Personal, Advisory Board: Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman Group, CMC Contrast, GSK, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, Daiichi Sankyo, Merck Sharp & Dome; Financial Interests, Personal, Speaker, Consultant, Advisor: Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman Group, CMC Contrast, GSK, Mundipharma, BMJ Journals, MedMedia, AstraZeneca, Daiichi Sankyo, Merck Sharp & Dome; Financial Interests, Personal, Invited Speaker: Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman Group, CMC Contrast, GSK, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, Merck Sharp & Dome; Financial Interests, Institutional, Sponsor/Funding: Roche; Financial Interests, Personal, Sponsor/Funding: Daiichi Sankyo. A.S. Berghoff: Financial Interests, Institutional, Research Funding: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Rochee; Financial Interests, Speaker, Consultant, Advisor: Roche, Bristol Myers Squibb, Merck, Daiichi Sankyo; Financial Interests, Sponsor/Funding, Travel: Roche, Amgen, AbbVie, Daiichi Sankyo. All other authors have declared no conflicts of interest.