Distribution of metastatic sites and survival analysis of patients with non-metastatic lung cancer at initial diagnosis based on hospital registration

王泽洲; 张　扬; 莫　淼; 袁　晶; 周昌明; 沈　洁; 冯小双; 吴浩旋; 李　航; 叶　挺; 胡　鸿; 陈海泉; 郑　莹

doi:10.19401/j.cnki.1007-3639.2021.09.002

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Distribution of metastatic sites and survival analysis of patients with non-metastatic lung cancer at initial diagnosis based on hospital registration

更新时间：2025-12-31

- Distribution of metastatic sites and survival analysis of patients with non-metastatic lung cancer at initial diagnosis based on hospital registration
- China Oncology Vol. 31, Issue 9, Pages: 775-782(2021)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院肿瘤预防部，复旦大学上海医学院肿瘤学系,上海,200032
  2. 复旦大学附属肿瘤医院胸外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2021.09.002
  CLC：
- Published Online：08 October 2021，
  
  Published：08 October 2021
- 稿件说明：
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王泽洲, 张　扬, 莫　淼, 袁　晶, 周昌明, 沈　洁, 冯小双, 吴浩旋, 李　航, 叶　挺, 胡　鸿, 陈海泉, 郑　莹 . 以医院登记为基础的初诊未转移肺癌患者的转移部位分布及生存分析[J]. 中国癌症杂志, 2021, 31(9): 775-782.

王泽洲, 张　扬, 莫　淼, et al. Distribution of metastatic sites and survival analysis of patients with non-metastatic lung cancer at initial diagnosis based on hospital registration[J]. China Oncology, 2021, 31(9): 775-782.
王泽洲, 张　扬, 莫　淼, 袁　晶, 周昌明, 沈　洁, 冯小双, 吴浩旋, 李　航, 叶　挺, 胡　鸿, 陈海泉, 郑　莹 . 以医院登记为基础的初诊未转移肺癌患者的转移部位分布及生存分析[J]. 中国癌症杂志, 2021, 31(9): 775-782. DOI： 10.19401/j.cnki.1007-3639.2021.09.002.

王泽洲, 张　扬, 莫　淼, et al. Distribution of metastatic sites and survival analysis of patients with non-metastatic lung cancer at initial diagnosis based on hospital registration[J]. China Oncology, 2021, 31(9): 775-782. DOI： 10.19401/j.cnki.1007-3639.2021.09.002.

摘要

背景与目的：通过分析以医院登记为基础的肺癌转移患者的转移部位分布和转移后生存状况，为肺癌患者的治疗和生存管理提供真实世界数据支持。方法：纳入2008—2017年于复旦大学附属肿瘤医院初诊未发生转移但在随访过程中发生转移的1 490例肺癌患者。通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存随访信息。研究诊断时年龄、性别和组织学亚型对转移分布的影响。应用Kaplan-Meier法估计不同转移部位的转移后总生存（overall survival，OS）率。结果：中位随访时间为40.8个月，随访期间全死因死亡937例。67.7%的患者仅发生单部位转移，而32.3%的患者有多部位转移。常见的转移部位依次为骨（33.8%）、脑（33.6%）、肺（22.8%）、肝（12.0%）和肾上腺（3.7%）。女性患者更容易发生脑转移（37.8% vs 31.4%），年轻患者更容易发生多部位转移，小细胞癌容易发生脑转移（47.2%）和肝转移（20.9%）。肺癌肺转移患者生存相对最好（1、3和5年OS率分别为78.3%、47.1%和29.5%），肝转移患者生存相对最差（1、3和5年OS率分别为46.4%、15.2%和3.6%）。结论：肺癌转移患者骨、脑转移比例较高，转移部位分布与性别、诊断时年龄和组织学亚型相关，不同转移部位的预后具有差异性。未来可针对不同转移部位进行机制或临床治疗方案研究，以改善晚期肺癌患者的预后。

Abstract

Background and purpose: We analyzed the distribution of metastatic sites and survival of lung cancer patients with metastases based on hospital registration to provide real-world data support for the treatment and survival management of lung cancer patients. Methods: A total of 1 490 lung cancer patients who developed metastasis during the follow-up in Fudan University Shanghai Cancer Center from 2008 to 2017 were enrolled in this study. Medical records review

telephone visits and death registry data linkage were applied in collecting endpoint data. The effects of age at diagnosis

gender and histological subtype on the distribution of metastases were studied. The Kaplan-Meier method was used to evaluate the overall survival (OS) rates of different metastatic sites. Results: The median follow-up time was 40.8 months. During the follow-up period

937 cases died from all causes. 67.7% of patients only had single-site metastasis

while 32.3% of patients had multiple-site metastases. The common metastatic sites were bone (33.8%)

brain (33.6%)

lung (22.8%)

liver (12.0%) and adrenal gland (3.7%). Female patients had more metastases to brain (37.8% vs 31.4%). Younger patients were more likely to develop multiple-site metastases

and small cell carcinomas patients had more brain metastases (47.2%) and liver metastases (20.9%). Lung metastasis featured relatively best survival (1-year OS rate: 78.3%

3-year OS rate: 47.1%

5-year OS rate: 29.5%)

whereas liver metastasis had relatively the worst prognosis (1-year OS rate: 46.4%

3-year OS rate: 15.2%

5-year OS rate: 3.6%). Conclusion: The proportions of bone and brain metastases in lung cancer patients with metastasis are high. The distribution of metastatic sites is associated with gender

age at diagnosis and histological type. The prognosis of patient with different metastatic sites is different. Mechanisms or clinical treatment plans can be studied for different metastatic sites to improve the prognosis of late-stage lung cancer patients in future research.

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