Clinical associations and prognostic value of site‑specific metastases in non‑small cell lung cancer: A population‑based study

Abstract

The prognosis of non-small cell lung cancer (NSCLC) is poor, particularly for patients with metastatic disease. Numerous efforts have been made to improve the prognosis of these patients; however, only a small number of studies have explored the occurrence rate and prognostic value of different patterns of distant metastasis (DM) in NSCLC systematically. To investigate these, information from patients diagnosed with NSCLC between 2010 and 2014 was collected from the Surveillance, Epidemiology and End Results database. Survival rate comparisons were performed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazard model was established to determine factors associated with improved overall survival (OS) and cancer-specific survival (CSS). The present study revealed that the most common site of single metastasis occurrence was bone, and the least common was the liver for NSCLC. As for multi-site metastases, the most common two-site metastasis involved bone and lung, and the most common three-site metastasis involved bone, liver and lung. As for NSCLC subtypes, large cell carcinoma (LCC) exhibited more specific metastatic features. The most common single metastatic site was the brain for patients with LCC, and the most common two-site metastatic combination was bone and liver. Patients with isolated liver metastasis exhibited the worst OS and CSS among patients with single metastasis. Furthermore, for patients with multi-site metastases, metastases involving the liver were associated with the worst OS and CSS among various combinations. To the best of our knowledge, the present study is the first to investigate the occurrence rate and prognostic value of different metastatic patterns of site-specific DM for NSCLC using a large population-based dataset. The findings of the present study may have vital implications for classifying patients with advanced NSCLC, thus laying a foundation for individualized precise treatment.

Clinical significance of site-specific metastases in pancreatic cancer: a study based on both clinical trial and real-world data

“…Previous studies showed that the numbers of distant metastases were significantly correlated with outcomes in some types of cancer 25 , 26 , but a similar correlation was not seen in pancreatic cancer. Oweira et al found no significant difference in OS between pancreatic cancer patients with single metastasis and multiple metastases (P=0.409) 10 .…”

Key prognostic factors for EGFR-mutated non-adenocarcinoma lung cancer patients in the Japanese Joint Committee of Lung Cancer Registry Database

“…Regarding distant metastasis, some studies have shown that the most frequent metastatic site of NSCLC is the bone, followed by the lung, brain, liver, and adrenal glands, and the most common combinations for two-site metastasis for SCC and LCLC were the bone and liver. On the other hand, lung and brain metastasis occurs more in EGFR-mutated NSCLC patients than in EGFR-wild type patients [17][18][19][20]. In any case, several studies have reported that liver metastasis has a poorer prognosis than other metastatic patterns [21,22].…”

Abdominal Pain as Initial Presentation of Lung Adenocarcinoma

“…Celiac lymph node metastases from internal organ malignancies are commonly observed with a reported incidence rate of 25-50% for all solid cancers, whereas only 5-10% of lung adenocarcinoma spread to the celiac lymph node. [1][2][3] Celiac lymph node metastasis usually originate from the lower lung more than the upper, probably due to proximity of the lower lung. Adenocarcinoma is the most frequent cell type, which accords with its propensity for earlier lymph node dissemination.…”