{"title":"非小细胞肺癌腹膜转移：临床特征、分子特征、诊断方法和结果的系统综述。","authors":"Ryuichi Ohta, Yoshinori Ryu, Kaoru Tanaka, Chiaki Sano, Hidetoshi Hayashi","doi":"10.2147/CMAR.S542123","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal metastasis is an uncommon but clinically significant manifestation of non-small cell lung cancer (NSCLC). While traditionally associated with gastrointestinal or ovarian malignancies, emerging reports suggest that NSCLC, particularly adenocarcinoma with driver mutations, can also exhibit peritoneal dissemination. This systematic review aims to synthesize current evidence on the clinical characteristics, diagnostic modalities, molecular profiles, treatment strategies, and outcomes of NSCLC patients with peritoneal metastasis.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science from inception through April 2025. Studies were eligible if they reported peritoneal metastasis in histologically confirmed NSCLC patients. Data on histopathology, molecular alterations, diagnosis, treatment, and survival were extracted. The review was conducted in accordance with PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Twenty-seven studies met inclusion criteria, comprising 19 case-based reports and seven retrospective cohort studies. Adenocarcinoma was the predominant histologic type (93%), and EGFR mutations were the most frequently reported molecular alteration. Diagnosis was primarily established via ascitic cytology, imaging, or intraoperative findings. Targeted therapy (eg, EGFR- or BRAF-directed TKIs) yielded temporary disease control in selected cases. However, median overall survival after peritoneal metastasis ranged from 2.0 to 5.2 months. Prognostic factors included poor performance status, absence of actionable mutations, and concurrent pleural metastasis.</p><p><strong>Conclusion: </strong>Peritoneal metastasis in NSCLC is rare but associated with poor prognosis. Molecular-guided therapies offer transient benefit, underscoring the need for early recognition and individualized treatment approaches. Prospective studies are warranted to better define predictors and optimal management strategies for this atypical metastatic pattern.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2127-2141"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456747/pdf/","citationCount":"0","resultStr":"{\"title\":\"Peritoneal Metastasis in Non-Small Cell Lung Cancer: A Systematic Review of Clinical Features, Molecular Profiles, Diagnostic Approaches, and Outcomes.\",\"authors\":\"Ryuichi Ohta, Yoshinori Ryu, Kaoru Tanaka, Chiaki Sano, Hidetoshi Hayashi\",\"doi\":\"10.2147/CMAR.S542123\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Peritoneal metastasis is an uncommon but clinically significant manifestation of non-small cell lung cancer (NSCLC). 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Adenocarcinoma was the predominant histologic type (93%), and EGFR mutations were the most frequently reported molecular alteration. Diagnosis was primarily established via ascitic cytology, imaging, or intraoperative findings. Targeted therapy (eg, EGFR- or BRAF-directed TKIs) yielded temporary disease control in selected cases. However, median overall survival after peritoneal metastasis ranged from 2.0 to 5.2 months. Prognostic factors included poor performance status, absence of actionable mutations, and concurrent pleural metastasis.</p><p><strong>Conclusion: </strong>Peritoneal metastasis in NSCLC is rare but associated with poor prognosis. Molecular-guided therapies offer transient benefit, underscoring the need for early recognition and individualized treatment approaches. 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引用次数: 0
摘要
腹膜转移是非小细胞肺癌（NSCLC）的一种罕见但有临床意义的表现。虽然传统上与胃肠道或卵巢恶性肿瘤相关，但新出现的报告表明，非小细胞肺癌，特别是具有驱动突变的腺癌，也可以表现为腹膜播散。本系统综述旨在综合目前关于非小细胞肺癌腹膜转移患者的临床特征、诊断方式、分子谱、治疗策略和预后的证据。方法：系统检索PubMed、Embase和Web of Science自建站至2025年4月的文献。如果研究报告组织学证实的非小细胞肺癌患者腹膜转移，则该研究是合格的。提取组织病理学、分子改变、诊断、治疗和生存的数据。该审查是根据PRISMA 2020指南进行的。结果：27项研究符合纳入标准，包括19项基于病例的报告和7项回顾性队列研究。腺癌是主要的组织学类型（93%），EGFR突变是最常见的分子改变。诊断主要通过腹水细胞学、影像学或术中发现确定。靶向治疗（例如，EGFR或brf导向的TKIs）在选定病例中获得了暂时的疾病控制。然而，腹膜转移后的中位总生存期为2.0至5.2个月。预后因素包括表现不佳、缺乏可操作的突变和并发胸膜转移。结论：非小细胞肺癌腹膜转移罕见，但预后较差。分子引导疗法提供了短暂的益处，强调了早期识别和个性化治疗方法的必要性。前瞻性研究有必要更好地定义这种非典型转移模式的预测因素和最佳管理策略。
Peritoneal Metastasis in Non-Small Cell Lung Cancer: A Systematic Review of Clinical Features, Molecular Profiles, Diagnostic Approaches, and Outcomes.
Introduction: Peritoneal metastasis is an uncommon but clinically significant manifestation of non-small cell lung cancer (NSCLC). While traditionally associated with gastrointestinal or ovarian malignancies, emerging reports suggest that NSCLC, particularly adenocarcinoma with driver mutations, can also exhibit peritoneal dissemination. This systematic review aims to synthesize current evidence on the clinical characteristics, diagnostic modalities, molecular profiles, treatment strategies, and outcomes of NSCLC patients with peritoneal metastasis.
Methods: A systematic literature search was conducted in PubMed, Embase, and Web of Science from inception through April 2025. Studies were eligible if they reported peritoneal metastasis in histologically confirmed NSCLC patients. Data on histopathology, molecular alterations, diagnosis, treatment, and survival were extracted. The review was conducted in accordance with PRISMA 2020 guidelines.
Results: Twenty-seven studies met inclusion criteria, comprising 19 case-based reports and seven retrospective cohort studies. Adenocarcinoma was the predominant histologic type (93%), and EGFR mutations were the most frequently reported molecular alteration. Diagnosis was primarily established via ascitic cytology, imaging, or intraoperative findings. Targeted therapy (eg, EGFR- or BRAF-directed TKIs) yielded temporary disease control in selected cases. However, median overall survival after peritoneal metastasis ranged from 2.0 to 5.2 months. Prognostic factors included poor performance status, absence of actionable mutations, and concurrent pleural metastasis.
Conclusion: Peritoneal metastasis in NSCLC is rare but associated with poor prognosis. Molecular-guided therapies offer transient benefit, underscoring the need for early recognition and individualized treatment approaches. Prospective studies are warranted to better define predictors and optimal management strategies for this atypical metastatic pattern.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
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