Metastatic characteristics and prognosis of non-small cell lung cancer

Zihan XU; Linpeng ZHENG; Qiao YANG; Feng LI; Yongxin YU; Jianguo SUN

doi:10.16016/j.1000-5404.201811089

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Metastatic characteristics and prognosis of non-small cell lung cancer

Clinical Medicine | 更新时间：2026-01-09

- Metastatic characteristics and prognosis of non-small cell lung cancer
- Journal of Third Military Medical University Vol. 41, Issue 9, Pages: 871-876(2019)
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院全军肿瘤研究所
- 作者简介：
- 基金信息：
  
  the National Natural Science Foundation for Young Scholars of China(8160111873)
- DOI：10.16016/j.1000-5404.201811089
  CLC： R181.23;R73-37;R734.2
- Received：13 November 2018，
  
  Revised：2019-02-11，
  
  Published：15 May 2019
- 稿件说明：
移动端阅览
Zihan XU, Linpeng ZHENG, Qiao YANG, et al. Metastatic characteristics and prognosis of non-small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(9): 871-876.
DOI：

Zihan XU, Linpeng ZHENG, Qiao YANG, et al. Metastatic characteristics and prognosis of non-small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(9): 871-876. DOI： 10.16016/j.1000-5404.201811089.

摘要

目的

基于大量人群的数据集，分析非小细胞肺癌(non-small cell lung cancer

NSCLC)转移部位的特异性及不同转移模式的预后差异。

方法

从SEER(Surveillance

Epidemiology

and End Results)数据库中收集2010-2014年诊断为NSCLC的转移性患者，利用Kaplan-Meier法和对数秩检验进行生存分析，通过Cox比例风险模型分析改善总体生存(overall survival

OS)的相关因素。

结果

从SEER数据库中收集到38 755例具有骨、肝、脑、肺任一部位转移的NSCLC患者。诊断时，年龄超过50岁的患者占93.89%，且以白种人为主(77.38%)。入组患者中，肿瘤中度分化(Ⅱ级)患者约占12.50%，肿瘤低分化(Ⅲ级)患者占25.55%，组织学亚型以腺癌为主，约占72.52%。对于所有NSCLC患者，最常见的单转移部位是骨(22.43%)，最少累及的部位是肝(5.87%)，骨和肺是最常见的双部位转移组合(7.40%)，骨、肝和肺是最常见的三部位转移组合(3.16%)。孤立性肝转移在单转移中具有最差的OS(

0.001)，多部位转移中，含有肝转移的组合也具有更差的OS(

0.001)。

结论

NSCLC不论是单个还是多个器官转移，骨都是最常累及的靶器官。单独肝转移或多部位联合肝转移的NSCLC患者预后较差，孤立性肺转移预后最好。

Abstract

Objective

To analyze the specificity of metastatic sites and prognostic differences of different metastatic patterns in non-small cell lung cancer (NSCLC) based on a large population-based dataset.

Methods

The metastatic NSCLC patients diagnosed between 2010 and 2014 were collected from the Surveillance

Epidemiology

and End Results (SEER) database. Kaplan-Meier survival analysis and log-rank test were used for survival analysis

and Cox proportional hazard model was performed to determine the factors related to improved overall survival (OS).

Results

A total of 38 755 NSCLC cases with metastases to bone

liver

brain and/or lungs were collected from the SEER database. At the time of diagnosis

93.89% of the patients were over the age of 50 years

and the caucasian accounted for 77.38%. Among all enrolled cases

the moderately differentiated tumors (grade Ⅱ) accounted for 12.50%

and those with poor differentiation (grade Ⅲ) for 25.55%. The major histological subtype was adenocarcinoma

accounting for 72.52%. The most common single metastatic site was bone (22.43%)

and the least common was liver (5.87%) for NSCLC. As for multi-site metastases

bone and lung was the most common 2-site metastasis (7.40%)

and bone

liver and lung was the most common 3-site metastasis (3.16%). An isolated liver metastasis had the worst OS among single metastasis (

0.001). Furthermore

for patients with multi-site metastases

liver combined metastases had worst OS among various combinations(

0.001).

Conclusion

For NSCLC

bone is the most commonly targeted site

no matter for single- or multi-organ metastases. NSCLC patients with metastasis to liver alone or in combination with other organs have a poorer prognosis

while isolated lung metastasis has the best outcomes.

关键词

Keywords

references

TORRE L A, BRAY F, SIEGEL R L, et al . Global cancer statistics, 2012[J ] . CA Cancer J Clin, 2015, 65(2): 87-108. DOI: 10.3322/caac.21262.

CRINÒ L, WEDER W, VAN MEERBEECK J, et al . Early stage and locally advanced(non-metastatic) non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up[J ] . Ann Oncol, 2010, 21(Suppl 5): v103-v115. DOI:10.1093/annonc/mdq207.

ZAGO G, MULLER M, VAN DEN HEUVEL M, et al . New targeted treatments for non-small-cell lung cancer—role of nivolumab[J ] . Biologics, 2016, 10: 103-117. DOI:10.2147/BTT.S87878.

LORUSSO G, IMBIMBO M, GARASSINO M C. Is the chemotherapy era in advanced non-small cell lung cancer really over? maybe not yet[J]. Tumori, 2016, 102(3): 223-225. DOI: 10.5301/tj.5000479.

MORGENSZTERN D, NG S H, GAO F, et al . Trends in stage distribution for patients with non-small cell lung cancer: a national cancer database survey[J ] . J Thorac Oncol, 2010, 5(1): 29-33. DOI: 10.1097/JTO.0b013e3181c5920c.

DETTERBECK F C, BOFFA D J, KIM A W, et al . The eighth edition lung cancer stage classification[J ] . Chest, 2017, 151(1): 193-203. DOI:10.1016/j.chest.2016.10.010.

REN Y J, DAI C Y, ZHENG H, et al . Prognostic effect of liver metastasis in lung cancer patients with distant metastasis[J ] .Oncotarget, 2016, 7(33): 53245-53253. DOI:10.18632/oncotarget.10644.

CHANG Y P, CHEN Y M, LAI C H, et al . The impact of de novo liver metastasis on clinical outcome in patients with advanced non-small-cell lung cancer[J ] . PLoS ONE, 2017, 12(6): e0178676. DOI: 10.1371/journal.pone.0178676.

EBERHARDT W E, MITCHELL A, CROWLEY J, et al . The IASLC lung cancer staging project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer[J ] . J Thorac Oncol, 2015, 10(11): 1515-1522. DOI:10.1097/JTO.000000000000 0673.

TAMURA T, KURISHIMA K, NAKAZAWA K, et al . Specific organ metastases and survival in metastatic non-small-cell lung cancer[J ] . Mol Clin Oncol, 2015, 3(1): 217-221. DOI: 10.3892/mco.2014.410.

RIIHIMÄKI M, HEMMINKI A, FALLAH M, et al .Metastatic sites and survival in lung cancer[J ] . Lung Cancer, 2014, 86(1): 78-84. DOI:10.1016/j.lungcan.2014.07.020.

WU K L, TSAI M J, YANG C J, et al . Liver metastasis predicts poorer prognosis in stage Ⅳ lung adenocarcinoma patients receiving first-line gefitinib[J ] . Lung Cancer, 2015, 88(2): 187-194. DOI: 10.1016/j.lungcan.2015.02.012.

PAZ-ARES L G, SHEN K, HIGGS B W, et al . Association of liver metastases(LM) with survival in NSCLC patients treated with durvalumab(D) in two independent clinical trials[J ] . J Clin Oncol, 2017, 35(15_suppl): 3038. DOI:10.1200/jco.2017.35.15_suppl.3038.

PILLAI R N, KAMPHORST A O, OWONIKOKO T K, et al . Liver metastases and sensitivity to checkpoint inhibition in patients with non-small cell lung cancer(NSCLC)[J ] . J Clin Oncol, 2016, 34(15_suppl): e20665.DOI:10.1200/jco.2016.34.15_suppl.e20665.

TUMEH P C, HELLMANN M D, HAMID O, et al . Liver metastasis and treatment outcome with anti-PD-1 monoclonal antibody in patients with melanoma and NSCLC[J ] . CancerImmunol Res, 2017, 5(5): 417-424. DOI:10.1158/2326-6066.CIR-16-0325.

YANG J, ZHANG Y, SUN X T, et al . The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: a SEER-based study[J ] . J Cancer Res Clin Oncol, 2018, 144(9): 1835-1842. DOI:10.1007/s00432-018-2702-9.

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