Metastatic pattern at autopsy in non-resectable adenocarcinoma of the lung--a study from a cohort of 259 consecutive patients treated with chemotherapy.

A cohort of 259 consecutive patients with non-resectable adenocarcinoma of the lung (ACL) received chemotherapy and were followed until death with 124 cases examined by autopsy (autopsy rate 48%). Metastatic sites were identified and the following localisations were affected in 40% or more of patients post mortem: lungs, mediastinal lymph nodes, liver, pleura, adrenals, brain, and bones. Significant more metastatic sites were observed in patients who responded to the chemotherapy compared with non-responders (p = 0.04), in patients aged below the median of 58 years compared with older patients (p = 0.002), and, as expected, in patients with initial extensive disease compared with limited disease (p = 0.03). In contrast, no differences in metastatic pattern at autopsy could be detected with regard to other variables, such as initial TNM-stages, degree of histological differentiation, histologic subtypes, performance status, or LDH.