Background Lung cancer metastasis to major organs is an important factor affecting survival. We analyzed the influence of patient characteristics on the incidence and survival of metastasis to major organs. MethodsWe collected data from the Surveillance, Epidemiology, and End Results database on 58 659 patients diagnosed with stage IV primary lung cancer, including age, sex, race, histological type of tumor, laterality, primary site, number of extrametastatic sites, and treatment. ResultsMultiple variables affected the incidence of metastasis to major organs and survival. According to histological type of tumor, the following were more common: bone metastasis from adenocarcinoma; brain metastasis from large-cell carcinoma and adenocarcinoma; liver metastasis from small-cell carcinoma; and intrapulmonary metastasis from squamous-cell carcinoma. A larger number of metastatic sites increased the risk of other metastases and shorter survival. Liver metastasis conferred the worst prognosis, followed by bone metastasis, and brain or intrapulmonary metastasis conferred better prognosis. The effect of radiotherapy alone was poorer than chemotherapy alone or combined chemotherapy and radiotherapy. In most cases, the effects of chemotherapy and combined chemotherapy and radiotherapy were equivalent. ConclusionMultiple variables affected the incidence of metastasis to major organs and survival. Compared with radiotherapy alone or combined chemotherapy and radiotherapy, chemotherapy alone may be the most costeffective option for patients with stage IV lung cancer.
BackgroundPneumonia is the main complication of the Omicron variant of SARS-CoV-2; however, the incidence proportions and prognostic factors for Omicron-associated pneumonia have not been established. We conducted this study to characterise the incidence proportions and influence of various factors on prognosis of Omicron-associated pneumonia.MethodsWe collected data from 714 patients infected with the Omicron variant in The First Affiliated Hospital of Chongqing Medical University (Chongqing, China) who were divided into different groups for analysis.ResultsWe identified 313 patients with Omicron-associated pneumonia at the time of diagnosis of patients infected with the Omicron variant, representing 43.8% of the entire cohort. A total of 82 were 15–59 years old, 71 were 60–69 years old, 76 were 70–79 years old and 84 were >80 years old. 133 were female and 180 were male. Incidence proportions of pneumonia were highest among patients with cardiovascular (82.4% of the basic disease of the cardiovascular system subset) or kidney disease (92.3% of the kidney disease subset), whereas patients with lung cancer (35.7% of the lung cancer subset) had a lower incidence proportion. Several factors were associated with the prognosis of pneumonia in patients infected with the Omicron variant. Patients with a thrombosis or pleural effusion had a longer hospitalisation time. Paxlovid and immunoglobulins improved the prognosis of patients with severe pneumonia. The following measures were significantly different in patients as a function of disease severity: number of neutrophils and lymphocytes, partial oxygen pressure; and myoglobin, lactic dehydrogenase, aspartate transaminase and procalcitonin levels.ConclusionPatients infected with the Omicron variant with coexisting cardiovascular or kidney disease, but not respiratory disease, had a higher incidence proportion of pneumonia. Paxlovid and immunoglobulins can be used in patients with severe infections to improve prognosis.
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