Original Research ARTICLE
Frequency and prognosis of pulmonary metastases in newly diagnosed gastric cancer
- 1Nanfang Hospital, Southern Medical University, China
Purpose The purpose of this study was to analyze the frequency and prognosis of pulmonary metastases in newly diagnosed gastric cancer using population-based data from SEER.
Methods Patients with gastric cancer and pulmonary metastases (GCPM) at the time of diagnosis in advanced gastric cancer were identified using the Surveillance, Epidemiology, and End Result (SEER) database of the National Cancer Institute from 2010 to 2014. Multivariable logistic and Cox regression were performed to identify predictors of the presence of GCPM at diagnosis and factors associated with all-cause mortality and gastric cancer-specific mortality. Survival curves were obtained according to the Kaplan-Meier method and compared using the log-rank test.
Results We identified 1104 patients with gastric cancer and pulmonary metastases at the time of diagnosis, representing 6.02% of the entire cohort and 15.19% of the subset with metastatic disease to any distant site. Among entire cohort, multivariable logistic regression identified six factors (younger, upper of stomach, intestinal-type, later T staging, later N staging and presence of more extrapulmonary metastases to liver, bone and brain) as positive predictors of the presence of pulmonary metastases at diagnosis. Median survival among the entire cohort with GCPM was 3.0 months (interquartile range: 1.0-9.0mo). Multivariable Cox model in SEER cohort confirmed five factors (diagnosis at previous period, black race, adverse pathology grade, absence of chemotherapy and presence of more extrapulmonary metastases to liver, bone and brain) as negative predictors for overall survival.
Conclusions The findings of this study provided population-based estimates of the frequency and prognosis for GCPM at time of diagnosis. These findings may provide preventive guidelines for screening and treatment of PM in GC patients. Patients with high risk factors should be given more attention before and after diagnosis.
Keywords: gastric cancer, Pulmonary metastases, Frequency, prognosis, SEER
Received: 25 Apr 2019;
Accepted: 09 Jul 2019.
Edited by:Kecheng Zhang, Department of General Surgery, Chinese PLA General Hospital, China
Reviewed by:San-Gang Wu, First Affiliated Hospital of Xiamen University, China
Zeming Liu, Zhongnan Hospital, Wuhan University, China
Copyright: © 2019 Sun, Liu, Yu, Huang, Han, Chen, Zhao, Hu, Jiang, Li and lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
MD, PhD. Yuming Jiang, Nanfang Hospital, Southern Medical University, Guangzhou, China, firstname.lastname@example.org
MD, PhD. Guo X. Li, Nanfang Hospital, Southern Medical University, Guangzhou, China, email@example.com