Prognostic factors for survival in patients with metastatic lung adenocarcinoma: An analysis of the SEER database

Background: Lung 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. Methods: Patients were selected from the Surveillance E...

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Detalles Bibliográficos
Autores: Campos-Balea, Begoña, de Castro Carpeño, Javier, Massutí, Bartomeu, Vicente-Baz, David, Pérez Parente, Diego, Ruiz-Gracia, Pedro, Crama, Leonardo, Cobo Dols, Manuel
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/17983
Acceso en línea:http://hdl.handle.net/20.500.12105/17983
Access Level:acceso abierto
Palabra clave:Lung adenocarcinoma
Metastasis
Non-small cell lung cancer
Overall survival
Prognostic factor
Adenocarcinoma del pulmón
Metástasis neoplásica
Carcinoma de pulmón de células no pequeñas
Pronóstico
Lung
Aged
Female
Humans
Male
Neoplasm Metastasis
Prognosis
SEER Program
Adenocarcinoma
Lung Neoplasms
Liver Neoplasms
Descripción
Sumario:Background: Lung 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. Methods: Patients 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. Results: A 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). Conclusions: The 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.