Comprehensive Analysis of Lung Cancer Metastasis: Sites, Rates, Survival, and Risk Factors—A Systematic Review and Meta-Analysis

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal Pub Date : 2025-07-11 DOI:10.1111/crj.70107

Shilin Wang, Wen Tang, Fu Jin, Huanli Luo, Han Yang, Ying Wang

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引用次数: 0

Abstract

Objectives

Lung cancer metastasis constitutes a critical aspect of disease progression and patient outcomes. It is imperative to illuminate the complex landscape of lung cancer metastasis, offering a thorough evaluation of sites, rates, risk factors, and survival implications.

Methods

Studies on the prevalence of lung cancer metastasis, the risk factors, the overall survival (OS) after metastasis, or the risk factors for OS were included. Two independent reviewers used a standardized data extraction and quality assessment form. Hazard ratios and confidence intervals were calculated using random-effects or fixed-effects models.

Results

This systematic meta-analysis included 115 clinical trials. Prevalent metastatic sites in non-small cell lung carcinoma (NSCLC) encompassed brain (29%), bone (25%), adrenal gland (15%), liver (13%), and skin (3%). However, small cell lung carcinoma (SCLC) primarily metastasized to liver (33%), brain (30%), bone (27%), adrenal gland (10%), and pericardium (3%). The risk factors for brain metastases in NSCLC included lung adenocarcinoma, EGFR mutations, and prophylactic cranial irradiation (PCI); in SCLC brain metastasis, age and PCI were influential. The median OS after brain metastasis in NSCLC and SCLC was 21.3 and 10.5 months, respectively, while liver or bone metastases were notably linked to poorer survival. The factors influencing OS in NSCLC brain metastasis included age, EGFR mutations, and stereotactic radiosurgery. For SCLC brain metastasis, OS was notably impacted by gender, smoking status, the number of brain metastases, and radiotherapy.

Conclusion

This study provided insights into lung cancer metastasis. The results revealed the metastatic rates, risk factors, and OS to assist clinical decision-making.

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肺癌转移的综合分析：部位、发生率、生存率和危险因素——一项系统综述和荟萃分析

目的肺癌转移是影响疾病进展和患者预后的重要因素。阐明肺癌转移的复杂格局，提供对部位、发生率、危险因素和生存影响的全面评估是必要的。方法对肺癌转移的发生率、危险因素、转移后总生存期（OS）及发生OS的危险因素进行研究。两名独立的审稿人使用了标准化的数据提取和质量评估表格。使用随机效应或固定效应模型计算风险比和置信区间。结果本系统荟萃分析包括115项临床试验。非小细胞肺癌（NSCLC）的常见转移部位包括脑（29%）、骨（25%）、肾上腺（15%）、肝脏（13%）和皮肤（3%）。然而，小细胞肺癌（SCLC）主要转移到肝脏（33%）、脑（30%）、骨（27%）、肾上腺（10%）和心包膜（3%）。NSCLC脑转移的危险因素包括肺腺癌、EGFR突变和预防性颅脑照射（PCI）；年龄和PCI是影响SCLC脑转移的因素。NSCLC和SCLC脑转移后的中位生存期分别为21.3个月和10.5个月，而肝或骨转移与较差的生存期明显相关。影响NSCLC脑转移OS的因素包括年龄、EGFR突变和立体定向放射手术。对于SCLC脑转移，OS明显受性别、吸烟状况、脑转移数量和放疗的影响。结论本研究为肺癌转移研究提供了新的思路。结果揭示了转移率、危险因素和OS，以辅助临床决策。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)