Clinical Features And Prognostic Factors Of Primary Lung Cancer-induced Metastasis

ObjectivesThe aims of this study is to: i).form understanding of clinical features of treatment-naive patients with lung cancer in The Tumor Hospital of Yunnan Province through collecting clinical datas retrospectively ;ii).investigate the clinical characteristics and the prognosis factors of lung cancer with bone metastases;brain metastases;liver metastases.MethodsClinical datas of patients firstly admitted to The Third Affiliated Hospital of Kunming Medical College(The Tumor Hospital of Yunnan Province) between 01/01/2014 and 12/31/2014 who were diagnosed of primary lung cancer was cllected 880 patients were included.Record relative information and laboratory indicators,telephone follow-up access to survival information.Useful datas will be analyzed with SPSS 20.0 software to find out characteristics of clinical features of treatment-naive patients with lung cancer. P<0.05 was considered to indicate a statistically significant difference.Find out characteristics of clinical features of lung cancer with bone metastases;brain metastases;liver metastase. Log-rank test of Kaplan-Meier to estimate survival rate for single factor analysis.Cox regression analysis method to estimate survival rate for multiple factors analysis.Results880 treatment-naive patients with primary lung cancer were included.The male to female ratio was 2.5:1.The median age was 58 years and 40 to 70 years old was the age vulnerable to primary lung cancer.There were 711 cases of NSCLC(80.8%).There were 474 cases of adenocarcinoma(53.9%), 226 cases of squamous cell carcinoma(25.7%), 132 cases of small cell carcinoma(15.0%),48 cases were others(5.4%).Stage ? and ? were a total of 693 cases(78.7%),of which 390 cases were stage IV(44.3%).The incidence of distant metastases was:bone metastases in 169 cases (43.33%),brain metastases in 88 cases(22.56%),double lung metastases in 86 cases (22.05%),pleural metastases in 73 cases (18.72%),liver metastases in 60 cases(15.38%),while other organ metastases are rare.Nutritional status of the patients with distant metastasis than without distant metastasis is worse.In patients with distant metastasis of the fibrinogen,blood viscosity,tumor markers were significantly increased.There were 169 cases of primary lung cancer with bone metastasis.The median age was 58 years and the male to female ratio was 1.5:1.The histology of the lung cancer included 117 patients with adenocarcinoma,22 patients with squamous cell carcinoma,and 48 cases with others.Furthermore,78.1% of patients exhibited multiple skeletal metastases at more than two sites and 55.6% of patients experienced skeletal-related events at the time of diagnosis.Kaplan-Meier analysis demonstrated that patients with adenocarcinoma,blood calcium,other existing organ metastases,lung surgery,chemotherapy,targeted treatment,89Sr treatment or bisphosphonates exhibited significantly longer survival times.Multivariate analysis identified the following independent predictors of OS:chemotherapy,targeted treatment and other existing organ metastases.There were 88 cases of primary lung cancer with brain metastasis.The median age was 58 years and the male to female ratio was 2:1.The histology of the lung cancer included 48 patients with adenocarcinoma,20 patients with small cell carcinoma,and 20 cases with others.Furthermore,72.7% of patients exhibited multiple brain metastases at more than two sites and 55.6% of patients experienced intracranial hypertension at the time of diagnosis.Kaplan-Meier analysis demonstrated that patients with aged <60 years old,histology,low albumin,chemotherapy,targeted treatment,WBRT or treatment modalities exhibited significantly longer survival times.Multivariate analysis identified the following independent predictors of OS:chemotherapy and targeted treatment.There were 60 cases of primary lung cancer with liver metastasis.The median age was 59.5 years and the male to female ratio was 3:1.The histology of the lung cancer included 23 patients with small cell carcinoma,21 patients with adenocarcinoma,and 16 cases with others.Furthermore,73.3% of patients exhibited multiple liver metastases at more than two sites and 55.6% of patients have a history of hepatitis.Kaplan-Meier analysis demonstrated that patients with histology,anti-tumor treatment or targeted treatment exhibited significantly longer survival times.Multivariate analysis identified the following independent predictors of OShistology and anti-tumor treatment.ConclusionsPrimary lung cancer has a younger trend.Nearly half of the newly diagnosed patients had metastasized.Nutritional status,liver and kidney function of the patients with distant metastasis than without distant metastasis is worse.In patients with distant metastasis of the hypercoagulable state,tumor markers were significantly increased.In the cohort of lung cancer patients with bone metastases at the time of diagnosis,adenocarcinoma and multiple skeletal metastases were most common.In lung cancer patients with bone metastases,multivariate analysis identified the following independent predictors of OS:chemotherapy,targeted treatment and other existing organ metastases.In lung cancer patients with brain metastases,multivariate analysis identified the following independent predictors of OS:chemotherapy and targeted treatment.In lung cancer patients with liver metastases,multivariate analysis identified the following independent predictors of OS:pathological type and antineoplastic therapy.