Metastasis dynamics for non-small-cell lung cancer: Effect of patient and tumor-related factors
| Autor: | Elia Biganzoli, Romano Demicheli, Marco Fornili, Jessamy A. Boyd, Federico Ambrogi, Chris R. Kelsey, Kristin Higgins |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Male Cancer Research Lung Neoplasms Lung cancer biology Metastasis Risk analysis/modeling Statistics Adenocarcinoma Adenocarcinoma Bronchiolo-Alveolar Adult Aged Aged 80 and over Carcinoma Large Cell Carcinoma Non-Small-Cell Lung Carcinoma Squamous Cell Female Follow-Up Studies Humans Middle Aged Neoplasm Metastasis Neoplasm Recurrence Local Neoplasm Staging Prognosis Risk Factors Young Adult Bronchiolo-Alveolar 80 and over Young adult Non-Small-Cell Lung Lymph node Hazard ratio Lymphovascular medicine.anatomical_structure Local Pulmonary and Respiratory Medicine medicine.medical_specialty Internal medicine medicine Carcinoma Lung cancer business.industry Large Cell medicine.disease Neoplasm Recurrence Squamous Cell business |
| Popis: | Background We studied event dynamics (probability of an event occurring over a specific time interval) in patients undergoing surgery for early-stage non–small-cell lung cancer (NSCLC) according to patient and tumor characteristics. Methods By using a database of 1506 patients who underwent initial surgery for NSCLC, event dynamics, based on a time-specific hazard rate, were evaluated. The event of interest was the development of distant metastases, with or without a local recurrence. The effect of sex, tumor size, nodal involvement, histology, lymphovascular space invasion, pleural invasion, age, and race were studied. Results The hazard rate for developing distant metastases was not constant over time but was characterized by specific peaks, the first being approximately 9 months after surgery and the second at 18 to 20 months for men and 24 to 26 months for women. For women, the hazard rate peaked considerably in the first year. For men, the hazard rate peaks were smaller but lasted for a longer duration. Pathologic factors associated with a higher risk of recurrence (eg, size, lymph node involvement, pleural invasion) all increased the sex-specific hazard rates. Conclusions The probability of developing distant metastases after surgery for NSCLC peaks at specific and consistent time intervals after surgery, with specific differences between men and women. A factor-specific modulation of peak heights that ranged from no impact (eg, race) to relevant effects for primary tumor size, nodal involvement, and pleural invasion, possibly related to sex, was also observed. The bimodal distant metastases dynamics may be an intrinsic feature of metastatic progression in NSCLC. |
| Databáze: | OpenAIRE |
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