Prognostic effect of liver metastasis in lung cancer patients with distant metastasis
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Yijiu Ren1,*, Chenyang Dai1,*, Hui Zheng1, Fangyu Zhou1, Yunlang She1, Gening Jiang1, Ke Fei1, Ping Yang2, Dong Xie1, Chang Chen1
1Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
2Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
*These authors contributed equally to this work
Chang Chen, email: email@example.com
Dong Xie, email: firstname.lastname@example.org
Keywords: lung cancer, distant metastasis, prognosis, surveillance epidemiology and end-results database
Received: March 14, 2016 Accepted: July 09, 2016 Published: July 18, 2016
Because the need of clinical prognostic evaluation by specific metastatic organ, we aim to analyze the prognostic factors in lung cancer patients with M1b disease with Surveillance Epidemiology and End-Results database (SEER). This retrospective study evaluated lung cancer patients of adenocarcinoma (AD), squamous cell carcinoma (SQCC), and small cell lung cancer (SCLC) selected from SEER. We provided the prognostic correlates of overall survival (OS) and lung cancer-specific survival (LCSS) in this population. 23,679 eligible patients were included. Bone was the most common metastatic site in AD (63.1%) and SQCC (61.1%), while liver was the most prevalent site (61.9%) in SCLC. Single site metastasis was significantly associated with better outcome compared to multiple sites metastases in all patients. Among patients with single site metastasis, OS and LCSS were longer for AD and SCLC if involving brain or bone, with median survival time of 5 to 7 months, comparing to 3 months if invloving liver (all p-values < 0.001). Similarly, among patients with multiple metastases, better outcomes were observed in AD patients (4 vs 3 months; OS and LCSS, p < 0.001) and SCLC patients (6 vs 4 months; OS, p = 0.017; LCSS, p = 0.023) without liver metastasis compared to those with liver metastasis. In conclusion, we estimated multiple survival outcomes by histology of primary tumor and sites of metastasis. Liver metastasis is found to be the worst prognostic factor for AD and SCLC patients with distant metastasis. More in-depth research is warranted to identify patients who are prone to develop distance metastasis, especially to liver.
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