Open Access

Clinical associations and prognostic value of site‑specific metastases in non‑small cell lung cancer: A population‑based study

  • Authors:
    • Zihan Xu
    • Qiao Yang
    • Xiewan Chen
    • Linpeng Zheng
    • Luping Zhang
    • Yongxin Yu
    • Mingjing Chen
    • Qiai You
    • Jianguo Sun
  • View Affiliations

  • Published online on: April 5, 2019     https://doi.org/10.3892/ol.2019.10225
  • Pages: 5590-5600
  • Copyright: © Xu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The prognosis of non‑small cell lung cancer (NSCLC) is poor, particularly for patients with metastatic disease. Numerous efforts have been made to improve the prognosis of these patients; however, only a small number of studies have explored the occurrence rate and prognostic value of different patterns of distant metastasis (DM) in NSCLC systematically. To investigate these, information from patients diagnosed with NSCLC between 2010 and 2014 was collected from the Surveillance, Epidemiology and End Results database. Survival rate comparisons were performed using Kaplan‑Meier analysis and log‑rank tests. A Cox proportional hazard model was established to determine factors associated with improved overall survival (OS) and cancer‑specific survival (CSS). The present study revealed that the most common site of single metastasis occurrence was bone, and the least common was the liver for NSCLC. As for multi‑site metastases, the most common two‑site metastasis involved bone and lung, and the most common three‑site metastasis involved bone, liver and lung. As for NSCLC subtypes, large cell carcinoma (LCC) exhibited more specific metastatic features. The most common single metastatic site was the brain for patients with LCC, and the most common two‑site metastatic combination was bone and liver. Patients with isolated liver metastasis exhibited the worst OS and CSS among patients with single metastasis. Furthermore, for patients with multi‑site metastases, metastases involving the liver were associated with the worst OS and CSS among various combinations. To the best of our knowledge, the present study is the first to investigate the occurrence rate and prognostic value of different metastatic patterns of site‑specific DM for NSCLC using a large population‑based dataset. The findings of the present study may have vital implications for classifying patients with advanced NSCLC, thus laying a foundation for individualized precise treatment.

References

1 

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J and Jemal A: Global cancer statistics, 2012. CA Cancer J Clin. 65:87–108. 2015. View Article : Google Scholar : PubMed/NCBI

2 

Crinò L, Weder W, van Meerbeeck J and Felip E; ESMO Guidelines Working Group, : Early stage and locally advanced (non-metastatic) non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 21 (Suppl 5):v103–v115. 2010. View Article : Google Scholar : PubMed/NCBI

3 

Zago G, Muller M, van den Heuvel M and Baas P: New targeted treatments for non-small-cell lung cancer-role of nivolumab. Biologics. 10:103–117. 2016.PubMed/NCBI

4 

Lo RG, Imbimbo M and Garassino MC: Is the chemotherapy era in advanced non-small cell lung cancer really over? Maybe not yet. Tumori. 2016:223–225. 2016.PubMed/NCBI

5 

Tamura T, Kurishima K, Nakazawa K, Kagohashi K, Ishikawa H, Satoh H and Hizawa N: Specific organ metastases and survival in metastatic non-small-cell lung cancer. Mol Clin Oncol. 3:217–221. 2015. View Article : Google Scholar : PubMed/NCBI

6 

Riihimäki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J and Hemminki K: Metastatic sites and survival in lung cancer. Lung Cancer. 86:78–84. 2014. View Article : Google Scholar : PubMed/NCBI

7 

Morgensztern D, Ng SH, Gao F and Govindan R: Trends in stage distribution for patients with non-small cell lung cancer: A national cancer database survey. J Thorac Oncol. 5:29–33. 2010. View Article : Google Scholar : PubMed/NCBI

8 

Detterbeck FC, Boffa DJ, Kim AW and Tanoue LT: The eighth edition lung cancer stage classification. Chest. 151:193–203. 2017. View Article : Google Scholar : PubMed/NCBI

9 

Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi AR III, Goldstraw P and Rami-Porta R; International Association for Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Board Members, Participating Institutions, : The IASLC lung cancer staging project: Proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 10:1515–1522. 2015. View Article : Google Scholar : PubMed/NCBI

10 

Chang YP, Chen YM, Lai CH, Lin CY, Fang WF, Huang CH, Li SH, Chen HC, Wang CC and Lin MC: The impact of de novo liver metastasis on clinical outcome in patients with advanced non-small-cell lung cancer. PLoS One. 12:e1786762017.

11 

Ren Y, Dai C, Zheng H, Zhou F, She Y, Jiang G, Fei K, Yang P, Xie D and Chen C: Prognostic effect of liver metastasis in lung cancer patients with distant metastasis. Oncotarget. 7:53245–53253. 2016. View Article : Google Scholar : PubMed/NCBI

12 

Surveillance, Epidemiology, and End Results (SEER) Program, . About the SEER program. simplehttp://www.seer.cancer.govJanuary 20–2017

13 

Abdel-Rahman O: Validation of the prognostic value of new sub-stages within the AJCC 8th edition of non-small cell lung cancer. Clin Transl Oncol. 19:1414–1420. 2017. View Article : Google Scholar : PubMed/NCBI

14 

Postmus PE, Brambilla E, Chansky K, Crowley J, Goldstraw P, Patz EJ Jr and Yokomise H; International Association for the Study of Lung Cancer International Staging Committee; Cancer Research and Biostatistics; Observers to the Committee, Participating Institutions, : The IASLC lung cancer staging project: Proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer. J Thorac Oncol. 2:686–693. 2007. View Article : Google Scholar : PubMed/NCBI

15 

Griffioen GH, Toguri D, Dahele M, Warner A, de Haan PF, Rodrigues GB, Slotman BJ, Yaremko BP, Senan S and Palma DA: Radical treatment of synchronous oligometastatic non-small cell lung carcinoma (NSCLC): Patient outcomes and prognostic factors. Lung Cancer. 82:95–102. 2013. View Article : Google Scholar : PubMed/NCBI

16 

Kuchuk M, Kuchuk I, Sabri E, Hutton B, Clemons M and Wheatley-Price P: The incidence and clinical impact of bone metastases in non-small cell lung cancer. Lung Cancer. 89:197–202. 2015. View Article : Google Scholar : PubMed/NCBI

17 

Derks JL, Hendriks LE, Buikhuisen WA, Groen HJ, Thunnissen E, van Suylen RJ, Houben R, Damhuis RA, Speel EJ and Dingemans AM: Clinical features of large cell neuroendocrine carcinoma: A population-based overview. Eur Respir J. 47:615–624. 2016. View Article : Google Scholar : PubMed/NCBI

18 

Milovanovic IS, Stjepanovic M and Mitrovic D: Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: An autopsy study. Ann Thorac Med. 12:191–198. 2017. View Article : Google Scholar : PubMed/NCBI

19 

Gibson A, Li H, D'Silva A, Tudor RA, Elegbede AA, Otsuka SM, Bebb DG and Cheung WY: Impact of number versus location of metastases on survival in stage IV M1b non-small cell lung cancer. Med Oncol. 35:1172018. View Article : Google Scholar : PubMed/NCBI

20 

Wu KL, Tsai MJ, Yang CJ, Chang WA, Hung JY, Yen CJ, Shen CH, Kuo TY, Lee JY, Chou SH, et al: Liver metastasis predicts poorer prognosis in stage IV lung adenocarcinoma patients receiving first-line gefitinib. Lung Cancer. 88:187–194. 2015. View Article : Google Scholar : PubMed/NCBI

21 

Dong F, Shen Y, Gao F, Xu T, Wang X, Zhang X, Zhong S, Zhang M, Chen S and Shen Z: Prognostic value of site-specific metastases and therapeutic roles of surgery for patients with metastatic bladder cancer: A population-based study. Cancer Manag Res. 9:611–626. 2017. View Article : Google Scholar : PubMed/NCBI

22 

Cai H, Wang H, Li Z, Lin J and Yu J: The prognostic analysis of different metastatic patterns in extensive-stage small-cell lung cancer patients: A large population-based study. Future Oncol. 14:1397–1407. 2018. View Article : Google Scholar : PubMed/NCBI

23 

Paz-Ares LG, Shen K, Higgs BW, Morehouse C, Rizvi NA, Segal NH, Jin X, Zheng Y, Narwal R, Gupta AK, et al: Association of liver metastases (LM) with survival in NSCLC patients treated with durvalumab (D) in two independent clinical trials. J Clin Oncol. 15:30382017. View Article : Google Scholar

24 

Pillai RN, Kamphorst AO, Owonikoko TK, Behera M, Behera S, Khuri FR, Ahmed R and Ramalingam SS: Liver metastases and sensitivity to checkpoint inhibition in patients with non-small cell lung cancer (NSCLC). J Clin Oncol. 15:e206652016. View Article : Google Scholar

25 

Tumeh PC, Hellmann MD, Hamid O, Tsai KK, Loo KL, Gubens MA, Rosenblum M, Harview CL, Taube JM, Handley N, et al: Liver metastasis and treatment outcome with anti-PD-1 monoclonal antibody in patients with melanoma and NSCLC. Cancer Immunol Res. 5:417–424. 2017. View Article : Google Scholar : PubMed/NCBI

26 

Socinski MA, Jotte RM, Cappuzzo F, Orlandi F, Stroyakovskiy D, Nogami N, Rodriguez-Abreu D, Moro-Sibilot D, Thomas CA, Barlesi F, et al: Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med. 378:2288–2301. 2018. View Article : Google Scholar : PubMed/NCBI

27 

Wu B, Wei S, Tian J, Song X, Hu P and Cui Y: Comparison of the survival time in the non-small cell lung cancer patients with different organ metastasis. Zhongguo Fei Ai Za Zhi. 22:105–110. 2019.(In Chinese). PubMed/NCBI

28 

Yang J, Zhang Y, Sun X, Gusdon AM, Song N, Chen L, Jiang G and Huang Y: The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: A SEER-based study. J Cancer Res Clin Oncol. 144:1835–1842. 2018. View Article : Google Scholar : PubMed/NCBI

29 

He YY, Zhang XC, Yang JJ, Niu FY, Zeng Z, Yan HH, Xu CR, Guan JL, Zhong WZ, Yang LL, et al: Prognostic significance of genotype and number of metastatic sites in advanced non-small-cell lung cancer. Clin Lung Cancer. 15:441–447. 2014. View Article : Google Scholar : PubMed/NCBI

30 

Blumenthal GM, Zhang L, Zhang H, Kazandjian D, Khozin S, Tang S, Goldberg K, Sridhara R, Keegan P and Pazdur R: Milestone analyses of immune checkpoint inhibitors, targeted therapy, and conventional therapy in metastatic non-small cell lung cancer trials: A meta-analysis. JAMA Oncol. 3:e1710292017. View Article : Google Scholar : PubMed/NCBI

31 

Herbst RS, Morgensztern D and Boshoff C: The biology and management of non-small cell lung cancer. Nature. 553:446–454. 2018. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

June 2019
Volume 17 Issue 6

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Xu, Z., Yang, Q., Chen, X., Zheng, L., Zhang, L., Yu, Y. ... Sun, J. (2019). Clinical associations and prognostic value of site‑specific metastases in non‑small cell lung cancer: A population‑based study. Oncology Letters, 17, 5590-5600. https://doi.org/10.3892/ol.2019.10225
MLA
Xu, Z., Yang, Q., Chen, X., Zheng, L., Zhang, L., Yu, Y., Chen, M., You, Q., Sun, J."Clinical associations and prognostic value of site‑specific metastases in non‑small cell lung cancer: A population‑based study". Oncology Letters 17.6 (2019): 5590-5600.
Chicago
Xu, Z., Yang, Q., Chen, X., Zheng, L., Zhang, L., Yu, Y., Chen, M., You, Q., Sun, J."Clinical associations and prognostic value of site‑specific metastases in non‑small cell lung cancer: A population‑based study". Oncology Letters 17, no. 6 (2019): 5590-5600. https://doi.org/10.3892/ol.2019.10225