Characteristics and survival difference of clinical tumor size 0 extensive-stage small cell lung cancer with different metastasis pattern

Correlation between tumor diameter, distant metastasis site, and survival in extensive stage small cell lung cancer

Background

Small cell lung cancer (SCLC) is a malignant disease that spreads quickly. There is limited research on the relationship between tumor diameter and distant metastatic patterns in extensive stage small cell lung cancer (ES-SCLC). This study aimed to investigate the relationship between tumor diameter, distant metastasis site, and survival in extensive stage small cell lung cancer.

Method

Patients over the age of 18 who applied to Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital with the diagnosis of small cell lung cancer and distant organ metastasis between January 2015 and December 2019 were retrospectively analyzed.

Results

The study comprised a total of 178 patients, with 12 women (6.7%) and 166 men (93.3%) participating. The patient was followed for a period of 1 to 36 months, with a median value of 7 months. The univariate model showed that pancreatic metastasis, single metastasis, tumor diameter, and tumor N stage had a significant (p = 0.003, p = 0.001, p = 0.013, p = 0.001, respectively) effect on survival. The N stage III group’s expected life expectancy [6.8 months (5.8–7.7)] was considerably (p = 0.000) lower than the N stage I–II groups [11.2 months (8.8–13.4)]. The predicted life expectancy for the group with pancreatic metastasis [4.1 months (2.6–5.5)] was significantly (p = 0.001) shorter than that of the group without pancreatic metastasis [8.9 months (7.6–10.1)]. The predicted life expectancy for the group with tumor size > 7 cm [6.7 months (5.4–8.0)] was significantly shorter than that of the group with tumor size of 0–3 cm [10.9 months (7.3–14.6)] (p = 0.019) and 3–7 cm [9.2 months (7.5–11)] (p = 0.023).

Conclusion

The authors of this study found that pancreatic metastasis, single metastasis, tumor diameter, and tumor N stage can be used as independent predictive factors for the survival of SCLC patients.

Different distant metastasis patterns based on tumor size could be found in extensive-stage small cell lung cancer patients: a large, population-based SEER study

BACKGROUND

Small-cell lung cancer (SCLC) is a malignant cancer with the ability to metastasize quickly. The relationship between tumor size and the distant metastasis patterns of Extensive-Stage Small Cell Lung Cancer (ES-SCLC) has not been reported.

OBJECTIVES

The aim of this study was to determine the different distant metastasis patterns as they related to tumor size in ES-SCLC.

PATIENTS AND METHODS

We used Surveillance, Epidemiology, and End Results (SEER) population-based data collected from 2010 through 2013 to identify 11058 ES-SCLC patients with definite evidence of distant metastases. Multivariate logistic regression analysis was used to demonstrate the association between tumor size and distant metastasis patterns including bone, liver, brain, and lung metastases. Age, race, sex, and N stage were also selected in the logistic regression model.

RESULTS

Subtle differences in metastasis patterns were found among patients based on different tumor sizes. Patients with tumors 3-7 cm have a higher risk of bone metastasis compared with those that have tumors ≤3 cm (OR 1.165, 95% CI [1.055-1.287], P = 0.003) and patients with tumors ≥7 cm have a higher risk of lung metastasis (OR 1.183, 95% CI [1.039-1.347], P = 0.011). In addition, patients with tumors ≥7 cm had a lower risk of brain metastasis and liver metastasis than patients with tumors ≤3 cm (OR 0.799, 95% CI [0.709-0.901], P < 0.001; OR 0.747, 95% CI [0.672-0.830], P < 0.001). Interestingly, there was no correlation between a larger tumor and a higher risk of metastasis. However, the tumor metastasis pattern did have some correlation with age, gender, race and N-status.

CONCLUSION

The pattern of distant metastasis of ES-SCLC is related to the tumor size and the tumor size is indicative of the metastatic site. Larger tumor sizes did not correlate with a higher risk of distant metastasis, but the size is related to the pattern of distant metastasis. The study of different distant metastasis patterns based on tumor size and other clinical features (e.g., age, race, sex, and N stage) in ES-SCLC is clinically valuable.