Supervisors info:
Κωνσταντίνος Νικ. Συρίγος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αναστασία Κοτανίδου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αικατερίνη Δημάκου, Διδάκτωρ, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction: Lung cancer is the leading cause of cancer death worldwide. 85% of cases are non-small cell lung cancer. Smoking in 85% is the major causative factor. Lung carcinomas when diagnosed are more common in metastatic stage IV in 57% with a 5-year survival not exceeding 4%. The liver, brain, bones, adrenal glands and the contralateral lung are the most common metastatic sites.
Aim: The purpose of this study was to investigate median overall survival (m OS) and median progression free survival (m PFS) of patients with metastatic non-small cell lung cancer in association with gender, smoking, histological subtype, metastatic disease stage (M1a, M1b, M1c), location of the metastases (intrathoracic, extrathoracic) and finally the number of affected organs with a metastatic site (1,2,> 2 organs).
Material and Methods: This is a retrospective study which recorded 100 patients with metastatic non-small cell lung cancer diagnosed at the 7th Respiratory Clinic of Sotiria Chest Hospital from May 2010 to June 2018. Their staging was according to the 8th revised TNM version.
Results: Overall, 100 patients were studied. Mean age 65.97 years (SD 8.96). 83 (83%) men. 90 smokers. 62 with adenocarcinoma, 21 with squamous cell carcinoma, 14 NSCLC-NOS (Non-Otherwise Specified) and 3 with large cell carcinoma. Median overall survival (m OS) was 7 months. 20 patients were M1a stage, 18 M1b and 62 M1c with corresponding mOS of 14, 6 and 5 months (p <0.001). Patients with squamous cell carcinoma had mOS of 10 months (p =0.046) compared to adenocarcinoma 6 months and NSCLC-NOS 5 months. In the initial diagnosis of the disease, cerebral metastases were present in 21 patients, splenic metastases in 2 patients, liver metastases in 26, bone metastases in 46, adrenal metastases in 19 patients, pleural and / or pericardial malignancy in 28 patients, and finally metastases in the contralateral lung in 43 patients.
Worse mOS of 5 months, had those with liver and bone metastases (p =0.031 and p =0.003, respectively). 43 patients with metastasis in one organ (No = 1), 37 in 2 organs (No = 2) and the rest 20 in more than 2 organs (No> 2) mOS of 10, 6 and 4 months respectively (p=0.003). The stage of metastatic disease (M1a M1b, M1c) was the only and most important negative prognostic factor of overall survival (p <0.001), whereas smoking was the only and most important negative prognostic factor in the disease progression free interval (p = 0.033).
Conclusion: The prognosis of patients with metastatic non-small cell lung cancer is poor. Factors such as the location of metastases, the number of organs with metastasis, the histological subtype but mainly the metastatic stage of the disease and the smoking habit appear to play a role in the course of the disease.
Keywords:
Lung cancer, Metastasis, Survival, Progression of disease
