Abstract
BACKGROUND: The necessity of conducting preoperative staging brain magnetic resonance imaging (MRI) for patients diagnosed with clinical stage IA lung adenocarcinoma (LUAD) is still a topic of discussion. The objective of this study was to explore the impact of staging brain MRI on survival outcomes in patients with clinical stage IA LUAD. METHODS: Patients diagnosed with clinical stage IA LUAD who received curative surgical treatment from May 2005 to December 2018 was selected for this analysis. To account for potential confounding variables, propensity score matching (PSM) was utilized. Survival outcomes including overall survival (OS) over a period of 10 years, 10-year recurrence-free survival (RFS), and 10-year brain metastasis-specific RFS were evaluated. Multivariate Cox regression analysis was conducted to determine the relationship between staging brain MRI and the evaluated survival outcomes. RESULTS: Of 593 clinical stage IA LUAD patients, 372 (median age: 57 years; 218 females) were recruited after dealing with confounding factors via PSM. No significant differences were found in 10-year OS, 10-year overall RFS and 10-year brain metastases-specific RFS between the group with and without staging brain MRI (all P>0.05). Multivariate analysis revealed that staging brain MRI was not associated with a significant improvement in OS [hazard ratio (HR), 2.35; 95% confidence interval (CI): 0.21-26.68; P=0.49], overall RFS (HR, 1.32; 95% CI: 0.75-2.31; P=0.33) or brain metastases-specific RFS (HR, 1.52; 95% CI: 0.60-3.84; P=0.38). CONCLUSIONS: For patients with clinical stage IA LUAD undergoing surgery, routine staging brain MRI may did not improve survival, suggesting that selective rather than universal use may be more appropriate.