Prognostic factors for survival in patients with metastatic lung adenocarcinoma: An analysis of the SEER database
Copyright policy )Prognostic factors for survival in patients with metastatic lung adenocarcinoma: An analysis of the SEER database
BackgroundLung adenocarcinoma (ADC) is the main cause of death related to lung cancer. The aim of this study was to identify poor prognostic factors for overall survival (OS) in patients with stage IV lung ADC in real‐world clinical practice.MethodsPatients were selected from the Surveillance Epidemiology and End Results (SEER) database. Chi‐square bivariate analysis was used for the association of binary qualitative variables. A multivariate Cox regression analysis was performed to determine the impact of these prognostic factors on OS.ResultsA total of 46 030 patients were included (51.3% men, mean age 67.03 ± 11.6), of whom 41.3% presented with metastases in bone, 28.9% in brain, 17.1% in liver and 31.8% in lung. Patients with liver metastases presented with two or more metastatic sites more frequently than patients without liver metastases (P < 0.001). Male sex (HR 0.78, 95% CI: 0.76–0.80), age ≥ 65 years (HR 1.37, 95% CI: 1.33–1.40), lack of family support (HR 0.80, 95% CI: 0.78–0.81) and presence of liver (HR 1.45, 95% CI: 1.40–1.50), bone (HR 1.21, 95% CI: 1.18–1.24) or brain metastases (HR 1.18, 95% CI: 1.15–1.21) were identified as poor prognostic factors for OS. Patients with liver metastasis showed the highest hazard ratio value (P < 0.001).ConclusionsThe presence of liver metastases was the worst prognostic factor for patients with metastatic lung ADC. This factor should be considered as a stratification factor for future studies evaluating new cancer treatments including immunotherapy.Key pointsSignificant findings of the study Regression analysis identified poor prognostic factors for overall survival. Factors were male sex, age ≥ 65 years, lack of family support and presence of liver, bone and brain metastases. Patients with liver metastasis showed the highest HR (HR = 1.45 95% CI: 1.40–1.50). This study included the highest number of adenocarcinoma patients analyzed so far (N = 46 030). What this study adds The presence of liver metastases should be considered as a stratification factor for future studies evaluating new cancer treatments including immunotherapy.
- Hospital Universitario Lucus Augusti Spain
- Hospital Universitario Virgen Macarena Spain
- Instituto de Salud Carlos III Spain
- University of Alicante Spain
- Roche (Switzerland) Switzerland
non‐small cell lung cancer, Lung adenocarcinoma, Male, Lung Neoplasms, *Lung adenocarcinoma, *overall survival, overall survival, Adenocarcinoma of Lung, Adenocarcinoma, Carcinoma de pulmón de células no pequeñas, Metastasis, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, *metastasis, Non-small cell lung cancer, Medical Subject Headings::Diseases::Neoplasms::Neoplastic Processes::Neoplasm Metastasis, Adenocarcinoma del pulmón, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma, metastasis, Humans, Overall survival, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms, Neoplasm Metastasis, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis, prognostic factor, Lung, RC254-282, non-small cell lung cancer, *prognostic factor, Metástasis neoplásica, Aged, Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Registries::SEER Program, Prognostic factor, Liver Neoplasms, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms, Pronóstico, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Medical Subject Headings::Check Tags::Female, Original Articles, Medical Subject Headings::Anatomy::Respiratory System::Lung, Prognosis, Medical Subject Headings::Check Tags::Male, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged, Female, *non-small cell lung cancer, SEER Program
non‐small cell lung cancer, Lung adenocarcinoma, Male, Lung Neoplasms, *Lung adenocarcinoma, *overall survival, overall survival, Adenocarcinoma of Lung, Adenocarcinoma, Carcinoma de pulmón de células no pequeñas, Metastasis, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, *metastasis, Non-small cell lung cancer, Medical Subject Headings::Diseases::Neoplasms::Neoplastic Processes::Neoplasm Metastasis, Adenocarcinoma del pulmón, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma, metastasis, Humans, Overall survival, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms, Neoplasm Metastasis, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis, prognostic factor, Lung, RC254-282, non-small cell lung cancer, *prognostic factor, Metástasis neoplásica, Aged, Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Registries::SEER Program, Prognostic factor, Liver Neoplasms, Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms, Pronóstico, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Medical Subject Headings::Check Tags::Female, Original Articles, Medical Subject Headings::Anatomy::Respiratory System::Lung, Prognosis, Medical Subject Headings::Check Tags::Male, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged, Female, *non-small cell lung cancer, SEER Program
selected citations These citations are derived from selected sources.This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).29 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
Citations provided by BIP!Popularity provided by BIP!