BACKGROUND: The purpose of this study is to compare the survival time of non-small cell lung cancer (NSCLC) patients with different organ metastasis. Among all cancers, the morbidity and mortality of lung cancer is the highest worldwide, which may caused by local recurrence and distant metastasis, and the location of metastasis may predict the prognosis of patients. METHODS: A total of 117,542 patients with NSCLC diagnosed between 2010 and 2014 were enrolled from Surveillance, Epidemiology, and End Result (SEER) databases, and the relationship between distant metastasis and survival time was retrospectively analyzed. RESULTS: Of all the 117,542 patients diagnosed with non-small cell lung cancer, 42,071 (35.8%) patients had different degrees of distant metastasis during their medical history, including 26,932 single organ metastases and 15,139 multiple organ metastases, accounting for 64.0% and 36.0% of the metastatic patients respectively. Compared with patients with no metastasis, whose median survival time was 21 months, the median survival time of patients with metastases was 7 months (lung), 6 months (brain), 5 months (bone), 4 months (liver), and 3 months (multiple organ) respectively, and the difference was significant (P<0.001, except liver vs multiple organ P=0.650); Most patients with NSCLC (88.4%) eventually died of lung cancer. CONCLUSIONS Distant metastasis of NSCLC patients indicates poor prognosis. In NSCLC patients with single organ metastasis, the prognosis of lung metastasis is the best, and liver metastasis is the worst, and multiple organ metastasis is worse than single organ metastasis.
Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; secondary ; Brain Neoplasms ; mortality ; secondary ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Liver Neoplasms ; mortality ; secondary ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVEThe aim of this study was to analyze the clinical features and prognostic factors in patients with brain metastasis from colorectal cancer (CRC).

METHODSClinical materials of 45 colorectal cancer patients who developed brain metastasis were collected, and the data and follow-up data of those patients were retrospectively analyzed.

RESULTSMost brain metastases were from rectal cancer (64.4%), and 80.0% of the 45 cases had extracranial metastases. The most common extracranial metastatic site was the lung (57.8%), followed by the liver (35.6%). All the brain metastases in patients with liver metastases were supratentorial, while in contrast, 44.8% of the patients without liver metastasis had subtentorial metastasis, showing a significant difference between them (P<0.05). The interval time from diagnosis of CRC to the development of brain metastases in case of Dukes D stage was 12.0 months, significantly shorter than that in the cases of Dukes A stage (24.0 months), B (36.0 months) and C (29.0 months) (P<0.05). The interval time was also shorter in the patients who developed extracranial metastasis within one year than those more than one year (12.0 months vs. 38.0 months)( P<0.05). The median survival time of patients with brain metastasis from colorectal was 6.0 months, with a 1-year survival rate of 21.1% and 2-year survival rate of 3.3% only. Univariate analysis showed that the median survival of patients with a KPS score of ≥70 was 8.0 months, significantly higher than 2.0 months in those with a KPS score of <70 (P<0.05). The median survival of patients with one or two brain metastases was 8.0 months, significantly higher than 4.0 months of those with >2 brain metastases (P<0.05). The median survival time after diagnosis of brain metastasis was 4.0 months for those who received monotherapy (only steroids, only chemotherapy or only radiotherapy), significantly shorter than 10.0 months of patients who received chemoradiotherapy, and 12.0 months of those who underwent surgery (P<0.05). Comparing each two differently treated groups, the survival time of surgery combined with chemotherapy or radiotherapy group was significantly different from that of all of other groups (P<0.05). The median survival time of chemoradiotherapy group was longer than that of monotherapy, but the difference was not significant (P>0.05). Multivariate analysis showed that brain metastases >2 and treatment modality type are independent prognostic factors for survival.

CONCLUSIONSPatients initially diagnosed with a Dukes D stage primary colorectal tumor and occurrence of extracranial metastasis (especially, pulmonary metastasis) within one year are associated to an increased risk of brain metastases and have a shorter survival time. Most brain metastases in patients with liver metastases are supratentorial, while many patients without liver metastasis have subtentorial metastasis. Brain metastases >2 and the type of treatment modality are independent prognostic factors for survival. The prognosis of patients who received chemoradiotherapy is better than those treated only with chemotherapy or radiotherapy. Some subsets of patients may benefit from surgery plus chemotherapy/radiotherapy.

Brain Neoplasms ; mortality ; secondary ; therapy ; Chemoradiotherapy ; Colorectal Neoplasms ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate ; Time Factors

OBJECTIVETo evaluate the survival rate after pulmonary resection for metastatic colorectal cancer(CRC).

METHODSClinical data of 77 patients with pulmonary metastasis from CRC between January 2005 and October 2008 in the Zhongshan Hospital, Fudan University were retrospectively analyzed.

RESULTSThere were 38 patients with synchronous pulmonary metastasis, of whom 2 underwent resection for pulmonary metastasis. The median survival time of two groups was 25 months and 18 months, which was not significantly different (P=0.33). There were 39 cases of metachronous pulmonary metastasis, of whom 28 received pulmonary metastasis resection. The 1-year and 3-year survival rates of 2 groups were 93.3% and 58.5%, and 38.8% and 19.1%, respectively. The median survival time of two groups was 26.7 months and 8 months, and the difference was statistically significant (P=0.004).

CONCLUSIONSurgical resection can improve the survival rate in patients with pulmonary metastasis from colorectal cancer.

Colorectal Neoplasms ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; secondary ; surgery ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the prognostic factors of small cell lung cancer (SCLC) and establish a reliable model of clinical prognostic index.

METHODSKaplan-Meier and Cox regression were used to analyze the relationship between survival time and prognostic factors in 60 cases of SCLC. The prognostic factors included clinical and laboratory parameters, serum cytokeratin fragment 19 (CYFRA21-1), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), CA125, interleukin-2 (IL-2) and soluble interleukin-2 receptors (sIL-2R).

RESULTSKaplan-Meier analysis showed that poor prognosis was in patients with KPS < 80 or extensive disease and unrelated to other clinical parameters such as age, sex and smoking index, and in patients with serum NSE > 30 micro g/L, CEA > 5.0 micro g/L, CA125 > 37 KU/L and sIL-2R > 500 KU/L. Serum IL-2 and CYFRA21-1 were also elevated, but had no significant prognostic value. Multivariate analysis indicated that serum NSE, stage and treatment of disease were independent prognostic factors. The three prognostic factors enabled establishment of a prognostic index (PI) based on a simple algorithm: PI = NSE (0 if < or = 30 micro g/L, 1 if > 30 microg/L) + stage (0 = LD, 1 = ED) + CEA (0 if < or = 5.0 microg/L, 1 if > 5.0 microg/L).

CONCLUSIONThe stage of disease, systemic treatment and the level of serum NSE are independent prognostic factors. Without considering the influence of treatment-related factors on survival, the levels of serum CEA, NSE and stage of disease before treatment are significant independent prognostic factors. PI calculated on the basis of CEA, NSE and stage is recommended to predict the survival of SCLC.

Adult ; Aged ; Biomarkers, Tumor ; blood ; Brain Neoplasms ; secondary ; Carcinoma, Small Cell ; mortality ; secondary ; therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; mortality ; pathology ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Survival Rate

OBJECTIVETo analyze a large cohort of patients with rectal cancer within a cancer center to determine the prognostic factors by univariate and multivariate analyses.

METHODSA total of 952 patients with rectal cancer were treated surgically during a period of 10 years. R0, R1 and R2 operations were carried out in 741 patients (77.8%), 75 patients (7.9%) and 136 patients (14.3%), respectively. There were more Miles operation (53.5%) than lower abdominal resection (LAR, 33.7%).

RESULTSThe operation mortality was 0.3%, 418 patients were dead within 108 months postoperatively due to recurrence or metastases to liver, lung and bone in 53, 39 and 12 patients. The overall mean survival time for all patients was 73.52 +/- 1.70 months and the overall 3-, 5-and 10-year survival rates were 67.6%, 55.4% and 38.2%. The overall 3-, 5- and 10-year survival rates for patients treated by radical operation were 81.4%, 70.3%, 48.8%, respectively. Kaplan-Meier estimate showed that patient gender, age, radicality of resection, histological type, liver and pulmonary metastasis and TNM stage were the predictors of survival. Multivariate analysis showed statistically significant correlation with radicality of operation, histological type, depth of tumor invasion, lymphatic invasion, TNM stage, liver and pulmonary metastasis.

CONCLUSIONFor survival, statistically significant differences among prognostic factors in relation to radicality of resection, lymphatic invasion, TNM stage, depth of tumor invasion, histological type, liver and pulmonary metastasis are found.

Adenocarcinoma ; mortality ; secondary ; surgery ; Adult ; Age Factors ; Aged ; Female ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Sex Factors ; Survival Rate

BACKGROUND/AIMS: Although the lung is the most common site of extrahepatic spread from hepatocellular carcinoma (HCC), the role of surgery for pulmonary metastasis remains unclear. The aim of this study was to evaluate the efficacy of pulmonary resection in patients with pulmonary metastasis from HCC. METHODS: Between July 2000 and July 2004, a total of 6 patients with pulmonary metastasis from HCC underwent curative pulmonary resections. The patients were divided into two groups (Surgery group and Non-surgery group) according to the primary treatment modality of HCC. Medical records, imaging studies, and pathologic reports of the surgical specimens were reviewed. RESULTS: Three patients in the surgery group underwent pulmonary resections for a solitary metastasis after hepatectomy for HCC, and they are all still alive. One of the 3 patients developed a tumor recurrence in the chest wall after pulmonary resection. The survival time after diagnosis of HCC were 79, 122, and 54 months, respectively. The survival time after pulmonary metastatectomy were 49, 39, and 20 months in the three patients. Another 3 patients in the non-surgery group, received a pulmonary metastatectomy; they had either a complete response HCC or partial radiologic response. These 3 patients developed recurrent disease in the liver. One of 3 patients died. The survival time after diagnosis of HCC were 153, 83, 12 months. The survival time after pulmonary metastatectomy were 51, 4, 2 months. CONCLUSIONS: The surgical resections of a solitary pulmonary metastasis from HCC in highly selected patients might be an effective treatment modalities for prolonged survival.
Adult ; Carcinoma, Hepatocellular/diagnosis/mortality/*secondary/*surgery ; Humans ; Liver Neoplasms/*pathology ; Lung Neoplasms/diagnosis/mortality/*secondary/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; *Pneumonectomy/mortality ; Survival Rate ; Treatment Outcome

OBJECTIVETo elucidate the efficacy and probable prognostic factors of surgical resection of pulmonary metastasis from colorectal cancer.

METHODSClinical data and outcomes of 35 colorectal patients with pulmonary metastasis undergone pulmonary metastasectomy were analyzed retrospectively.

RESULTSMedian follow-up time was 48.0 months. The median overall survival time was 36.0 months. Five-year survival rate was 33.0%. Nineteen patients died of tumor progression. Sixteen patients were survival including survival with tumor (10 cases) and without tumor (6 cases). One patient was still alive without tumor for 164 months. Univariate analysis revealed that disease free interval (DFI) was a prognostic risk factor, while gender, age, primary tumor site, pulmonary metastasis size and location, surgical procedure, pre-surgical CEA level, re-metastasectomy did not show influence on the survival time after pulmonary metastasectomy.

CONCLUSIONSFor some selected patients with indication, pulmonary metastasectomy may be a potential curative method. DFI may be associated with the prognosis after pulmonary metastasectomy.

Colorectal Neoplasms ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; secondary ; surgery ; Male ; Middle Aged ; Pneumonectomy ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

BACKGROUND: Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis. METHODS: The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated. RESULTS: The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05). CONCLUSIONS The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.
Aged ; Bone Marrow ; pathology ; Bone Marrow Neoplasms ; mortality ; pathology ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Small Cell Lung Carcinoma ; pathology

OBJECTIVETo analyze the clinical characteristics, survival and prognosis of breast cancer patients under 30 years of age.

METHODS129 breast cancer patients under 30 years treated from Jan 1980 to May 2000 were retrospectively reviewed. Clinical features, survival and prognostic factors were analyzed by SPSS 10.0 statistic software.

RESULTSBreast cancer patients under 30 years accounted for 2.6% of all breast cancers in our hospital. The overall 5- and 10-year survival rates were 61.5% and 46.7%, respectively. For patients with tumor < or = 3 cm or > 3 cm, the 10-year survival rates were 65.5% and 27.4% (P < 0.01). For those with number of positive axillary lymph nodes 0, 1-3, or > or = 4, the 10-year survival rates were 79.5%, 40.9% or 31.4% (P < 0.01). For patients who had been treated with or without tamoxifen, the 10-year survival rates were 63.7% and 45% (P < 0.01). For those complicated with pregnancy and lactation which was found in 24.8% of such patients, the 10-year survival rate was 44.3%. In the multivariate analysis, independent prognostic factors that might improve the overall survival were tumor size, axillary metastatic status and tamoxifen treatment.

CONCLUSIONBreast cancer patients aged 30 years and younger may have good prognosis if multimodality treatment is given. Tumor size, axillary metastatic status and tamoxifen treatment are independent prognostic factors. Prognosis of patients, either complicated with pregnancy and lactation or not, is quite similar if the clinical stage is the same and if being treated by the combined therapy.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Breast Neoplasms ; mortality ; pathology ; therapy ; Carcinoma, Ductal, Breast ; mortality ; secondary ; therapy ; Carcinoma, Medullary ; mortality ; secondary ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lactation ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate ; Tamoxifen ; administration & dosage

Hypertrophic osteoarthropathy is characterized by clubbing of the digital tips and periosteal reaction of long bones. Most of the cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia, and gastrointestinal polyps. Hypertrophic osteoarthropathy associated with malignancy is rare in children. A few cases of hypertrophic osteoarthropathy in children with nasopharyngeal carcinoma have been reported, however, there has been no report of such case in Korea. We present a case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma with lung metastasis in a 14-yr-old boy. In this case, hypertrophic osteoarthropathy regressed after intensive chemotherapy, but subsequently the patient died of progressive lung metastasis.
Adolescent ; Bone and Bones/radiography ; Carcinoma/*diagnosis/mortality ; Disease Progression ; Fatal Outcome ; Human ; Joint Diseases/pathology ; Lung Neoplasms/mortality/*secondary ; Male ; Nasopharyngeal Neoplasms/*diagnosis/mortality ; Neoplasm Metastasis ; Osteoarthropathy, Primary Hypertrophic/*diagnosis/mortality/radiography ; Prognosis