The landscape of small cell lung cancer metastases: Organ specificity and timing.
metastasis pattern
small cell lung cancer
survival
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
09
12
2020
accepted:
06
01
2021
pubmed:
4
2
2021
medline:
20
11
2021
entrez:
3
2
2021
Statut:
ppublish
Résumé
Early metastasis is a hallmark of small cell lung cancer (SCLC). However, the mechanisms and resulting patterns of SCLC dissemination are unclear. Our aim was thus to investigate the organ specificity and timing of blood-borne metastases in a comprehensive large cohort of SCLC patients. In this retrospective non-interventional cross-sectional study of 1009 Caucasian SCLC patients, we investigated the correlation between the distinct locations of the primary tumor and metastatic sites. The onset of bone (p < 0.001), brain (p < 0.001), and pericardial (p = 0.02) metastases were late events, whereas adrenal gland (p = 0.005) and liver (p < 0.001) metastases occurred earlier. No significant difference was found in the distribution of early versus late metastases when comparing central and peripheral primary tumors. Patients with bone metastases had a higher than expected likelihood of having liver metastases, while brain metastases tended to appear together with adrenal gland metastases. Pleural and both lung and pericardial metastases also tended to co-metastasize together more frequently than expected if metastatic events occurred independently. Notably, patients with central primary tumors had decreased median overall survival (OS) compared to those with peripheral tumors, although this tendency does not appear to be significant (p = 0.072). Our results are suggestive for particular site- and sequence-specific metastasis patterns in human SCLC. SCLC bone metastases tend to appear together with liver metastases, while brain metastases occur together with adrenal gland metastases. Better understanding of metastasis distribution patterns might help to improve the diagnosis and therapeutic decision-making in SCLC patients.
Sections du résumé
BACKGROUND
Early metastasis is a hallmark of small cell lung cancer (SCLC). However, the mechanisms and resulting patterns of SCLC dissemination are unclear. Our aim was thus to investigate the organ specificity and timing of blood-borne metastases in a comprehensive large cohort of SCLC patients.
METHODS
In this retrospective non-interventional cross-sectional study of 1009 Caucasian SCLC patients, we investigated the correlation between the distinct locations of the primary tumor and metastatic sites.
RESULTS
The onset of bone (p < 0.001), brain (p < 0.001), and pericardial (p = 0.02) metastases were late events, whereas adrenal gland (p = 0.005) and liver (p < 0.001) metastases occurred earlier. No significant difference was found in the distribution of early versus late metastases when comparing central and peripheral primary tumors. Patients with bone metastases had a higher than expected likelihood of having liver metastases, while brain metastases tended to appear together with adrenal gland metastases. Pleural and both lung and pericardial metastases also tended to co-metastasize together more frequently than expected if metastatic events occurred independently. Notably, patients with central primary tumors had decreased median overall survival (OS) compared to those with peripheral tumors, although this tendency does not appear to be significant (p = 0.072).
CONCLUSION
Our results are suggestive for particular site- and sequence-specific metastasis patterns in human SCLC. SCLC bone metastases tend to appear together with liver metastases, while brain metastases occur together with adrenal gland metastases. Better understanding of metastasis distribution patterns might help to improve the diagnosis and therapeutic decision-making in SCLC patients.
Identifiants
pubmed: 33533174
doi: 10.1111/1759-7714.13854
pmc: PMC7952793
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
914-923Subventions
Organisme : Hungarian National Research, Development and Innovation Office
ID : K129065
Organisme : Hungarian National Research, Development and Innovation Office
ID : KH130356
Organisme : Austrian Science Fund
ID : FWF I3522
Organisme : Austrian Science Fund FWF
ID : I 3522
Pays : Austria
Organisme : Hungarian Academy of Sciences
ID : Bolyai Research Scholarship
Organisme : New National Excellence Program of the Ministry for Innovation and Technology
ID : UNKP-20-3
Organisme : Hungarian National Research, Development and Innovation Office
ID : NVKP_16-1-2016-0004
Organisme : New National Excellence Program of the Ministry for Innovation and Technology
ID : UNKP-19-4
Organisme : Hungarian National Research, Development and Innovation Office
ID : NAP2-2017-1.2.1- NKP-0002
Organisme : Open Access funding was provided by Semmelweis University (SE).
Organisme : Austrian Science Fund
ID : FWF I3977
Organisme : Hungarian National Research, Development and Innovation Office
ID : KNN121510
Organisme : Austrian Science Fund
ID : I4677
Informations de copyright
© 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
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