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.
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.
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.