Metastatic Pattern in Non-resectable Non-small Cell Lung Cancer

Abstract

This study describes the metastatic pattern at autopsy in patients with non-resectable non-small cell lung cancer (NSCLC) and evaluates the impact of various pretreatment variables and treatment outcomes on the metastatic spread. In eight phase II chemotherapy trials from 1985 through 1993, 337 patients were treated and 51 autopsies were performed (autopsy rate 15%). The male/female ratio was 31/20, median age 56 years (range 36-71), response rate to chemotherapy 8%, and median survival 88 days (range 3-899). Histologic types included adenocarcinoma, 31 cases (60%), squamous cell carcinoma, 9 cases (18%), large cell carcinoma, 9 cases (18%), and unclassified NSCLC, 2 cases (4%). Patients who were autopsied had a shorter median survival than patients without autopsy (p = 0.002, log-rank test). Most commonly involved metastatic sites found at autopsy were mediastinal lymph nodes (84%), pleura (51%), liver (47%), bone (34%), brain (32%), pericardium (29%), adrenals (29%). The median number of involved organs was 5 (range 1-16), with a median of 3 intrathoracic sites (range 1-8) and 2 extrathoracic sites (range 0-11). Patients who initially had metastatic NSCLC also had significantly more metastatic sites at autopsy both extrathoracic (p = 0.004) and totally (p = 0.03) compared to patients with locally advanced disease. No other relation to pretreatment variables was found.

Stage IV colorectal cancer primary site and patterns of distant metastasis

“…Prior investigation into other primary cancer sites (i.e., breast, lung) supports the paradigm that primary tumor characteristics, including tumor site and molecular markers, can inform the pattern of metastatic spread [8–10]. Consistent with the findings presented here, previous epidemiologic research also indicates a relationship between primary CRC tumor site and the synchronous pattern of metastasis to the liver and/or lungs, with three past studies specifically noting that patients with rectal primaries were, compared to colon cancer patients, more likely to present with lung metastases and less likely to present with liver metastases at diagnosis.…”

Lymphatic drug delivery using engineered liposomes and solid lipid nanoparticles

“…The potential of targeted therapies and imaging agents to the lungs are great, considering intrathoracic lymph node metastasis are common in small cell lung cancer, occurring in about 70% of the limited stage patients and to nearly 80% of the extensive stage patients [51]. In the case of the other more common type of lung cancer- non small cell lung cancer, greater than 80% of stage IV patients showing extensive metastasis to the lymphatics [52]. …”

A Metastatic Jejunal Tumor from Squamous Cell Carcinoma of the Lung Found in an Intestinal Perforation

“…The most common metastatic sites are the other lung (50%), liver (37%), adrenal gland (31%), bone (29%), kidneys (18%), and brain (12%), but the frequency of metastasis to the digestive tract is rare (2.8–8.8%) [1, 2, 3]. Furthermore, in various reports, the rate of metastatic intestinal tumors from lung cancer was about 0.1–3% [3, 4].…”

“…While the 50% cumulative survival rate for obstruction was about 3 months, that for perforation was about 1.7 months [11]. Since the prognosis of the lung cancer itself is poor and peritonitis further decreases the patient's condition, it was thought that the prognosis of patients who underwent surgery for a metastatic intestinal tumor was especially poor [1, 2, 3, 5]. In the present case, the patient died about 2 months after he was transferred to his former hospital (about 3 months after surgery).…”