Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Thorac Cancer. 2023 Mar;14(8):736-745. doi: 10.1111/1759-7714.14801. Epub 2023 Jan 24.
This study aims to characterize the specific organ metastatic rates in lung adenocarcinoma (LUAD) patients and identify the prognosis-associated factors.
Using the Surveillance, Epidemiology and End Results database, 40 117 patients diagnosed with positive histology as the only primary LUAD were included. We stratified patients by diagnosed year, age, sex, race/ethnicity, marital status, insurance, location, TNM stage, organ-specific metastases, surgery, chemotherapy, and radiation therapy. We performed multivariable logistic and Cox regression to identify the factors associated with the presence of specific organ metastases and prognosis predictors.
For the 40 117 LUAD patients, 43.69%, 26.25%, 19.66%, 10.60%, and 17.89% had specific organ, bone, brain, liver, and lung metastases, respectively. The average survival in patients with organ metastases was 12.19 months, compared to 36.40 months in patients without metastases. In different kinds of metastatic organ cohorts, the longest average survival was 12.60 months in the lung metastases cohort, and the shortest was 8.43 months in liver metastases cohort. In total, 571 patients with metastases received surgery, which was significantly associated with decreased mortality (hazard ratio 1.82, 95% confidence interval 1.65-2.01, p < 0.01). Patients received surgery of lobectomy or extended (251 of 571, 43.96%) displayed the longest average survival (35.16 months); patients (294 of 571, 51.49%) received sub-lobar resection, had the average survival (19.90 months); patients received local tumor destruction (26 of 571, 4.55%) had the shortest average survival (13.73 months).
This study provides insights into the specific organ metastatic rates and prognosis in LUAD patients on a population level. These findings suggest that surgery resection should be taken into consideration in the treatment for these LUAD patients.
本研究旨在描述肺腺癌（LUAD）患者特定器官转移率的特征，并确定与预后相关的因素。
使用监测、流行病学和最终结果数据库，纳入了 40117 名经组织学诊断为 LUAD 的患者。我们根据诊断年份、年龄、性别、种族/民族、婚姻状况、保险、位置、TNM 分期、特定器官转移、手术、化疗和放疗对患者进行分层。我们进行了多变量逻辑回归和 Cox 回归分析，以确定与特定器官转移和预后预测因素相关的因素。
在 40117 例 LUAD 患者中，分别有 43.69%、26.25%、19.66%、10.60%和 17.89%的患者存在特定器官、骨、脑、肝和肺转移。有器官转移的患者的平均生存时间为 12.19 个月，而无转移的患者为 36.40 个月。在不同类型的转移性器官队列中，肺转移队列的平均生存时间最长为 12.60 个月，肝转移队列的平均生存时间最短为 8.43 个月。在总计 571 例有转移的患者中，有 571 例（571 例中的 571 例）接受了手术治疗，这与死亡率降低显著相关（风险比 1.82，95%置信区间 1.65-2.01，p<0.01）。接受肺叶切除术或扩大切除术（571 例中的 251 例，43.96%）的患者显示出最长的平均生存时间（35.16 个月）；接受亚肺叶切除术（571 例中的 294 例，51.49%）的患者平均生存时间（19.90 个月）；接受局部肿瘤破坏（571 例中的 26 例，4.55%）的患者平均生存时间最短（13.73 个月）。
本研究提供了 LUAD 患者人群水平上特定器官转移率和预后的见解。这些发现表明，手术切除应在 LUAD 患者的治疗中考虑。
