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. 2022 Mar 22;14(7):1608.
doi: 10.3390/cancers14071608.

Heterogeneity of Synchronous Lung Metastasis Calls for Risk Stratification and Prognostic Classification: Evidence from a Population-Based Database

Shuncong Wang  1 , Lei Chen  1 , Yuanbo Feng  1 , Johan V Swinnen  2 , Charles Jonscher  3 , Chantal Van Ongeval  4 , Yicheng Ni  1
Affiliations

Heterogeneity of Synchronous Lung Metastasis Calls for Risk Stratification and Prognostic Classification: Evidence from a Population-Based Database

Shuncong Wang et al. Cancers (Basel). .

Abstract

The epidemiology and associated potential heterogeneity of synchronous lung metastasis (sLM) have not been reported at a population-based level. Cancer patients with valid information about sLM status in the Surveillance, Epidemiology, and End Results database were enrolled. The prevalence of sLM, with a 95% confidential interval, and median survival of sLM, with interquartile range, were calculated and compared by Chi-square analyses and log-rank tests by primary cancer type and clinicopathological factors. Furthermore, the risk factors of sLM development were identified by multivariate logistic regression. Among 1,672,265 enrolled cases, 3.3% cases were identified with sLM, with a median survival of 7 months. Heterogeneity in prevalence and prognosis in sLM was observed among different primary cancers, with the highest prevalence in main bronchus cancer and best survival in testis cancer. Higher prevalence and poorer prognosis were observed in the older population, male population, African American, patients with lower socioeconomic status, and cases with advanced T stage, N stage, or more malignant pathological characteristics. Race, age, T stage, N stage, metastasis to other sites, insurance status and marital status were associated with sLM development (p < 0.001). The current study highlights the heterogeneity of the prevalence and prognosis in patients with sLM.

Keywords: SEER; cancer; epidemiology; lung; metastasis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence and prognosis of sLM cases by primary cancer. (A) Prevalence of synchronous sLM by cancer type in all cancer patients (including metastatic and non-metastatic cancer patients); (B) Ratio of synchronous sLM by cancer type in patients with metastatic lesions; (C) Distribution of primary cancer in patients with sLM; (D) Median survival of cancer patients with sLM. Abbreviations: STS: soft tissue sarcoma; GI: gastrointestinal cancer; GU: genitourinary cancer.
Figure 2
Figure 2
Disparities in prevalence and prognosis for sLM by age (A,B), race (C,D), sex (E,F), T stage (G,H), and N stage (I,J). Statistical tests were performed by Chi-square analyses and log-rank tests. Abbreviation: AA: African American.
Figure 3
Figure 3
Disparities in prevalence and prognosis for sLM by insurance (A,B), marital status (C,D), residence type (E,F), county-level income (G,H), and county-level education (I,J). Statistical tests were performed by Chi-square analyses and log-rank tests.
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