Comparison of metastasis and treatment patterns among different histopathologic types of lung cancer: analysis of 6 years of nationwide lung cancer cohort data in Korea.

IF 4 2区 医学 Q2 ONCOLOGY
Translational lung cancer research Pub Date : 2025-02-28 Epub Date: 2025-01-21 DOI:10.21037/tlcr-24-770
Jeong Uk Lim, Kyu Yean Kim, Ho Cheol Kim, Tae-Jung Kim, Hong Kwan Kim, Mi Hyoung Moon, Kyongmin Sarah Beck, Yang Gun Suh, Chang Hoon Song, Jin Seok Ahn, Jeong Eun Lee, Jae Hyun Jeon, Chi Young Jung, Jeong Su Cho, Yoo Duk Choi, Seung Sik Hwang, Young Sik Park, Soon Ho Yoon, Joon Young Choi, Chang-Min Choi, Seung Hun Jang
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引用次数: 0

Abstract

Background: Personalized management of stage IV lung cancer requires a deeper understanding of metastatic patterns and the potential benefits of localized treatments for each histologic type. This study aims to identify patterns of both intrathoracic and extrathoracic metastases across various histologic types of lung cancer using a nationwide Korean lung cancer database.

Methods: The study analyzed data from patients diagnosed with lung cancer between 2014 and 2019, sourced from the Korean Association of Lung Cancer Registry (KALC-R). Patients with stage IV lung cancer, indicated by M staging, were included to focus on metastatic patterns.

Results: The cohort included 7,562 stage IV lung cancer patients, with adenocarcinoma being the most prevalent histologic type, comprising 49.22% of cases (3,722 patients). M stage categorization showed that 27.3% were M1a, 56.3% M1b, 15.7% M1c, and 0.6% unspecified. The adenosquamous type had the highest proportion of patients with metastases in three or more organs (42.9%). Metastases to the liver and bones were consistently associated with decreased survival across histologic types. In adenocarcinoma, strong associations were observed between extrathoracic metastatic sites, particularly between bone and liver [odds ratio (OR) =3.93] and liver and adrenal glands (OR =2.85). Multivariate analysis revealed that patients receiving radiotherapy to lung lesions had significantly better overall survival (OS) [hazard ratio (HR) =0.68; 95% confidence interval (CI): 0.60-0.78; P<0.001] compared to those who did not. Radiotherapy to extrathoracic metastases also significantly improved survival (HR =0.84; 95% CI: 0.77-0.93; P<0.001).

Conclusions: Understanding metastasis patterns and treatment options specific to each lung cancer histologic type is essential for improving treatment strategies.

不同组织病理类型肺癌转移和治疗模式的比较:对韩国6年全国肺癌队列数据的分析
背景:IV期肺癌的个性化管理需要更深入地了解转移模式和针对每种组织学类型的局部治疗的潜在益处。本研究旨在利用韩国全国肺癌数据库确定不同组织学类型肺癌的胸内和胸外转移模式。方法:该研究分析了2014年至2019年被诊断为肺癌的患者的数据,这些数据来自韩国肺癌登记协会(KALC-R)。以M分期为指标的IV期肺癌患者被纳入研究,重点关注转移模式。结果:该队列包括7,562例IV期肺癌患者,腺癌是最常见的组织学类型,占病例的49.22%(3,722例)。M分期分类显示,27.3%为M1a, 56.3%为M1b, 15.7%为M1c, 0.6%未明确。腺鳞癌转移到三个或更多器官的比例最高(42.9%)。转移到肝脏和骨骼的肿瘤始终与各种组织学类型的生存率降低相关。在腺癌中,胸外转移部位之间存在很强的相关性,尤其是骨和肝脏之间[比值比(OR) =3.93]以及肝脏和肾上腺之间(OR =2.85)。多因素分析显示,接受肺部病变放疗的患者总生存期(OS)显著提高[危险比(HR) =0.68;95%置信区间(CI): 0.60-0.78;结论:了解每种肺癌组织学类型的转移模式和治疗方案对于改进治疗策略至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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