Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai, 200433, China.
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
J Cancer Res Clin Oncol. 2018 Sep;144(9):1835-1842. doi: 10.1007/s00432-018-2702-9. Epub 2018 Jul 12.
This study aimed to investigate the prognostic value of different organs metastases in patients with non-small cell lung cancer (NSCLC) and its most common subtypes.
We identified 45,423 NSCLC cases (25,129 men and 20,294 women) between 2010 and 2013 with distant metastases, with complete clinical information obtained from the surveillance, epidemiology, and end results (SEER) database.
Bone and liver were the most and the least common metastatic sites with rates of 37.1 and 16.8%, respectively. The mortality rates associated with bone, brain, liver, lung metastases, and multiorgan metastases (MOM) were 73.2, 72.7, 78.3, 65.4, and 77.5%, respectively. Kaplan-Meier analyses demonstrated that patients with MOM and liver metastasis had the worst survival. Compared with NSCLC cases with other organ metastasis, but without the four organs metastasis, hazard ratios (HRs) for lung, bone, brain, and liver metastases, and MOM were 0.906 (95% CI 0.866-0.947), 1.276 (95% CI 1.225-1.330), 1.318 (95% CI 1.260-1.379), 1.481 (95% CI 1.388-1.580), and 1.647 (95% CI 1.587-1.709), respectively. Similar results were obtained for adenocarcinoma (AD) cases.
The mortality risk is highest with MOM and liver metastasis followed by bone, brain, other organ, and lung metastases in NSCLC and AD which is the most common variant for NSCLC. These results will be helpful for pre-treatment evaluation regarding the prognosis of NSCLC patients.
本研究旨在探讨非小细胞肺癌（NSCLC）及其最常见亚型患者不同器官转移的预后价值。
我们从监测、流行病学和最终结果（SEER）数据库中确定了 2010 年至 2013 年间 45423 例有远处转移的 NSCLC 病例（男性 25129 例，女性 20294 例），并获得了完整的临床资料。
骨和肝是最常见和最不常见的转移部位，转移率分别为 37.1%和 16.8%。骨、脑、肝、肺转移和多器官转移（MOM）相关的死亡率分别为 73.2%、72.7%、78.3%、65.4%和 77.5%。 Kaplan-Meier 分析表明，MOM 和肝转移患者的生存最差。与 NSCLC 病例有其他器官转移但无上述四个器官转移的患者相比，肺、骨、脑和肝转移以及 MOM 的风险比（HRs）分别为 0.906（95%CI 0.866-0.947）、1.276（95%CI 1.225-1.330）、1.318（95%CI 1.260-1.379）、1.481（95%CI 1.388-1.580）和 1.647（95%CI 1.587-1.709）。腺癌（AD）病例也得到了类似的结果。
在 NSCLC 和 AD 中，MOM 和肝转移的死亡率风险最高，其次是骨、脑、其他器官和肺转移，AD 是 NSCLC 最常见的变异型。这些结果将有助于 NSCLC 患者预后的治疗前评估。
