New insights into the impact of primary lung adenocarcinoma location on metastatic sites and sequence: A multicenter cohort study

Research output: Contribution to journalJournal article – Annual report year: 2018Researchpeer-review

  • Author: Klikovits, Thomas

    Medical University of Vienna, Austria

  • Author: Lohinai, Zoltán

    National Korányi Institute of Pulmonology, Hungary

  • Author: Fabian, Katalin

    Semmelweis University, Hungary

  • Author: Gyulai, Marton

    County Hospital of Pulmonology, Hungary

  • Author: Szilasi, Mária

    University of Debrecen, Hungary

  • Author: Varga, Judit

    Szent György Hospital, Hungary

  • Author: Baranya, Erika

    National Korányi Institute of Pulmonology, Hungary

  • Author: Pipek, Orsolya

    Eötvös Loránd University, Hungary

  • Author: Csabai, István

    Eötvös Loránd University, Hungary

  • Author: Szallasi, Zoltan

    Cancer Genomics, Department of Bio and Health Informatics, Technical University of Denmark, Kemitorvet, 2800, Kgs. Lyngby, Denmark

  • Author: Tímár, József

    Semmelweis University, Hungary

  • Author: Hoda, Mir Alireza

    Medical University of Vienna, Austria

  • Author: Laszlo, Viktoria

    Medical University of Vienna, Austria

  • Author: Hegedűs, Balázs

    University Hospital Essen, Germany

  • Author: Renyi-Vamos, Ferenc

    Semmelweis University, Hungary

  • Author: Klepetko, Walter

    Medical University of Vienna, Austria

  • Author: Ostoros, Gyula

    National Korányi Institute of Pulmonology, Hungary

  • Author: Döme, Balázs

    Semmelweis University, Hungary

  • Author: Moldvay, Judit

    National Korányi Institute of Pulmonology, Hungary

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Introduction: The presence of organ metastases is a major factor for unfavorable prognosis in lung adenocarcinoma (LADC). However, the influence of primary tumor location on metastatic sites and sequence has not been extensively analyzed. Methods: We performed a multicenter cohort study, evaluating clinicopathological data of 1126 Caucasian LADC patients, focusing on the distinct location of primary tumors and metastatic sites during disease progression. Results: Metastases to the lung (p < 0.001), pleura (p < 0.001) and adrenal glands (p < 0.001) occurred earlier during disease progression and central primary tumors were associated with early metastases (OR 1.43, p = 0.02). In secondary exploratory analysis we found that bone metastases were more frequent in patients with central tumors (OR 1.86, p = 0.017), whereas lung metastases in those with peripheral tumors (OR 1.35, p = 0.015). Central primary LADCs were associated with decreased median overall survival (vs. peripheral tumors, 10.2 vs. 22 months) both in univariate (HR 2.075, p = 0.001) and in multivariate (HR 1.558, p < 0.001) analyses and independent from stage and T factor. By subsequent analysis, we found that bone metastases tend to appear together with adrenal and liver metastases, and adrenal with skin, and pleural with pericardial metastases more frequently than expected if metastatic events occurred independently. Conclusion: This comprehensive large cohort analysis demonstrates metastatic site- and sequence-specific variations in patients with LADC. Central LADC is associated with early metastatic disease, bone involvement and, consequently, decreased survival.
Original languageEnglish
JournalLung Cancer
Volume126
Pages (from-to)139-148
ISSN0169-5002
DOIs
Publication statusPublished - 2018
CitationsWeb of Science® Times Cited: No match on DOI

    Research areas

  • Lung adenocarcinoma, Metastases, Primary tumor location, Survival, Metastatic sites

ID: 161880769