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. 2017 Jul;9(7):1903-1910.
doi: 10.21037/jtd.2017.06.117.

Prognostic significance of sites of extrathoracic metastasis in patients with non-small cell lung cancer

James E Bates  1 , Michael T Milano  2
Affiliations

Prognostic significance of sites of extrathoracic metastasis in patients with non-small cell lung cancer

James E Bates et al. J Thorac Dis. 2017 Jul.

Abstract

Background: Metastatic non-small cell lung cancer (NSCLC) continues to have a poor prognosis despite recent advances in both targeted radiotherapy methodologies such as stereotactic body radiotherapy (SBRT) and immunotherapies. The impact of location of metastatic disease in patients with NSCLC has not been investigated; we aimed to investigate this using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods: We included 39,910 patients from the SEER database treated for M1b NSCLC from 2010-2013. We identified patients with metastatic disease in the brain, lung, liver, and bone. We used Kaplan-Meier analyses and Cox proportional hazards models to assess the impact of varying sites of metastatic disease on overall survival (OS).

Results: Patients with disease coded as in the brain without other disease in the lung, liver, or bone had improved OS relative to all other comers with M1b disease (HR =0.84, 95% CI, 0.84-0.90, P<0.001). Likewise, patients with disease coded as in the bone without other disease in the lung, liver, or brain had improved OS relative to all other comers with M1b disease (HR =0.89, 95% CI, 0.86-0.92, P<0.001).

Conclusions: This hypothesis-generating analysis suggests that patients with limited metastatic NSCLC to the bone or brain may particularly benefit from aggressive upfront therapies.

Keywords: Non-small cell lung cancer (NSCLC); Surveillance, Epidemiology, and End Results (SEER); extrathoracic metastasis; oligometastases; survival.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curve of patients with M1b non-small cell lung cancer in the brain-group (i.e., without lung, bone or liver metastases) compared to all other M1b patients.
Figure 2
Figure 2
Kaplan-Meier survival curve of patients with M1b non-small cell lung cancer in the bone-group (i.e., without lung, brain or liver metastases) compared to all other M1b patients.
See this image and copyright information in PMC

References

    1. Turajlic S, Swanton C. Metastasis as an evolutionary process. Science 2016;352:169-75. 10.1126/science.aaf2784 - DOI - PubMed
    1. de Groot PM, Carter BW, Betancourt Cuellar SL, et al. Staging of lung cancer. Clin Chest Med 2015;36:179-96. 10.1016/j.ccm.2015.02.004 - DOI - PubMed
    1. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol 1995;13:8-10. 10.1200/JCO.1995.13.1.8 - DOI - PubMed
    1. Weichselbaum RR, Hellman S. Oligometastases revisited. Nat Rev Clin Oncol 2011;8:378-82. - PubMed
    1. Fleckenstein J, Petroff A, Schafers HJ, et al. Long-term outcomes in radically treated synchronous vs. metachronous oligometastatic non-small-cell lung cancer. BMC Cancer 2016;16:348. 10.1186/s12885-016-2379-x - DOI - PMC - PubMed

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