The impact of de novo liver metastasis on clinical outcome in patients with advanced non-small-cell lung cancer

Yu Ping Chang, Yu Mu Chen, Chien Hao Lai, Chiung Yu Lin, Wen Feng Fang, Cherng Hua Huang, Shau Hsuan Li, Hung Chen Chen, Chin Chou Wang, Meng Chih Lin

Research output: Contribution to journalJournal Article peer-review

23 Scopus citations

Abstract

Liver metastasis has been found to affect outcome in prostate cancer and colorectal cancer, but its role in lung cancer is unclear. The current study aimed to evaluate the impact of de novo liver metastasis (DLM) on stage IV non-small cell lung cancer (NSCLC) outcomes and to examine whether tyrosine kinase inhibitors (TKI) reverse poor prognosis in patients with DLM and epidermal growth factor receptor (EGFR)-mutant NSCLC. Among 1392 newly diagnosed NSCLC patients, 490 patients with stage IV disease treated between November 2010 and March 2014 at Kaohsiung Chang Gung Memorial Hospital were included. Patients were divided into two groups according to DLM status. There were 75 patients in the DLM group and 415 patients in the non-DLM group. The DLM group included more patients with bone metastasis, fewer patients with a lymphocyte-to-monocyte ratio (LMR) > 3.1, and fewer patients with pleural metastasis. In the DLM group, Eastern Cooperative Oncology Group performance status 3-4 and LMR □3.1 were associated with poor outcome. In patients without DLM, overall survival (OS) was longer in patients with EGFR-mutant NSCLC than in those without (20.2 vs. 7.3 months, p < 0.001). Among DLM patients, OS was similar between the EGFR-mutant and wild-type EGFR tumor subgroups (11.9 vs. 7.7 months, p = 0.155). We found that DLM was a significant poor prognostic factor in the EGFR-mutant patients treated with EGFRTKIs, whereas DLM did not affect the prognosis of EGFR-wild-type patients.

Original languageEnglish
Article numbere0178676
JournalPLoS ONE
Volume12
Issue number6
DOIs
StatePublished - 06 2017

Bibliographical note

Publisher Copyright:
© 2017 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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