Department of Radiotherapy, Taixing Clinical College of Bengbu Medical College, Bengbu, China.
Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Medicine (Baltimore). 2023 Jul 21;102(29):e34251. doi: 10.1097/MD.0000000000034251.
This study aimed to investigate the impact of distinct metastasis patterns on the overall survival (OS) of individuals diagnosed with organ metastatic lung squamous cell carcinoma (LUSC). OS was calculated using the Kaplan-Meier method, and univariate and multivariate Cox regression analyses were conducted to further assess prognostic factors. A total of 36,025 cases meeting the specified criteria were extracted from the Surveillance, Epidemiology, and End Results database. Among these patients, 30.60% (11,023/36,025) were initially diagnosed at stage IV, and 22.03% (7936/36,025) of these individuals exhibited metastasis in at least 1 organ, including the liver, bone, lung, and brain. Among the 4 types of single metastasis, patients with bone metastasis had the lowest mean OS, at 9.438 months (95% CI: 8.684-10.192). Furthermore, among patients with dual-organ metastases, those with both brain and liver metastases had the shortest mean OS, at 5.523 months (95% CI: 3.762-7.285). Multivariate Cox regression analysis revealed that metastatic site is an independent prognostic factor for OS in patients with single and dual-organ metastases. Chemotherapy was beneficial for patients with single and multiple-organ metastases; although surgery was advantageous for those with single and dual-organ metastases, it did not affect the long-term prognosis of patients with triple organ metastases. Radiotherapy only conferred benefits to patients with single-organ metastasis. LUSC patients exhibit a high incidence of metastasis at the time of initial diagnosis, with significant differences in long-term survival among patients with different patterns of metastasis. Among single-organ metastasis cases, lung metastasis is the most frequent and is associated with the longest mean OS. Regarding treatment options, patients with single-organ metastasis can benefit from chemotherapy, surgery, and radiotherapy, and those with metastasis in 2 organs can benefit from chemotherapy and surgery. Patients with metastasis in more than 2 organs, however, can only benefit from chemotherapy. Understanding the variations in metastasis patterns assists in guiding pretreatment assessments and in determining appropriate therapeutic interventions for LUSC.
本研究旨在探讨不同转移模式对诊断为器官转移性肺鳞癌(LUSC)个体的总生存期(OS)的影响。OS 使用 Kaplan-Meier 方法进行计算,并进行单变量和多变量 Cox 回归分析以进一步评估预后因素。从 Surveillance, Epidemiology, and End Results 数据库中提取了 36025 例符合指定标准的病例。在这些患者中,30.60%(11023/36025)最初被诊断为 IV 期,其中 22.03%(7936/36025)的患者至少有 1 个器官转移,包括肝、骨、肺和脑。在 4 种单转移类型中,骨转移患者的平均 OS 最低,为 9.438 个月(95%CI:8.684-10.192)。此外,在双器官转移患者中,同时有脑和肝转移的患者的平均 OS 最短,为 5.523 个月(95%CI:3.762-7.285)。多变量 Cox 回归分析显示,转移部位是单器官和双器官转移患者 OS 的独立预后因素。化疗对单器官和多器官转移患者有益;尽管手术对单器官和双器官转移患者有利,但对三器官转移患者的长期预后没有影响。放疗仅对单器官转移患者有益。LUSC 患者在初始诊断时转移发生率较高,不同转移模式的患者长期生存存在显著差异。在单器官转移病例中,肺转移最为常见,且与最长的平均 OS 相关。关于治疗选择,单器官转移患者可从化疗、手术和放疗中获益,2 个器官转移患者可从化疗和手术中获益,而多个器官转移患者只能从化疗中获益。了解转移模式的变化有助于指导治疗前评估和确定 LUSC 的适当治疗干预措施。