Single organ metastatic disease and local disease status, prognostic factors for overall survival in stage IV non-small cell lung cancer: Results from a population-based study

L. E. Hendriks*, J. L. Derks, P. E. Postmus, R. A. Damhuis, R. M.A. Houben, E. G.C. Troost, M. M. Hochstenbag, E. F. Smit, A. M.C. Dingemans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

50 Citations (Scopus)

Abstract

Purpose:

To analyse the prognostic impact on overall survival (OS) of single versus multiple organ metastases, organ affected, and local disease status in a population based stage IV non-small cell lung cancer (NSCLC) cohort. 

Methods:

In this observational study, data were analysed of all histologically confirmed stage IV NSCLC patients diagnosed between 1 January 2006 and 31 December 2012 registered in the Netherlands Cancer Registry. Location of metastases before treatment was registered. Multivariable survival analyses [age, gender, histology, M-status, local disease status, number of involved organs, actual organ affected] were performed for all patients and for an 18fluorodeoxyglucose-positron emission tomography (18FDG-PET)-staged subgroup. 

Results:

11,094 patients were selected: 60% male, mean age 65 years, 73% adenocarcinoma. Median OS for 1 (N = 5676), 2 (N = 3280), and ≥3 (N = 2138) metastatically affected organs was 6.7, 4.3, 2.8 months, respectively (p < 0.001). Hazard ratio (HR) for 2 versus 1 organ(s) was 1.33 (p < 0.001), for ≥3 versus 1 organ(s) 1.91 (p < 0.001). Results were confirmed in the 18FDG-PET-staged cohort (N = 1517): patients with single organ versus 2 and ≥3 organ metastases had higher OS (8.6, 5.7, 3.8 months, HR 1.40 and 2.17, respectively, p < 0.001). In single organ metastases, OS for low versus high TN-status was 8.5 versus 6.5 months [HR 1.40 (p < 0.001)]. 18FDG-PET-staged single organ metastases patients with low TN-status had a superior OS than those with high TN-status (11.6 versus 8.2 months, HR 1.62, p < 0.001). 

Conclusion:

Patients with single organ metastases stage IV NSCLC have a favourable prognosis, especially in combination with low TN status. They have to be regarded as a separate subgroup of stage IV disease.

Original languageEnglish
Pages (from-to)2534-2544
Number of pages11
JournalEuropean Journal of Cancer
Volume51
Issue number17
DOIs
Publication statusPublished - Nov 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Ltd.

Fingerprint

Dive into the research topics of 'Single organ metastatic disease and local disease status, prognostic factors for overall survival in stage IV non-small cell lung cancer: Results from a population-based study'. Together they form a unique fingerprint.

Cite this