Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Abstract Background Patients with pulmonary large cell carcinoma (LCC) have a high incidence of synchronous brain metastases (SBM) and a poor prognosis. Our study was to evaluate the predictive and prognostic value of the clinical characteristics of pulmonary LCC patients with SBM at initial diagnos...

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Main Authors: Xuan Zheng, Shuai Mu, Lijie Wang, Haitao Tao, Di Huang, Ziwei Huang, Xiaoyan Li, Pengfei Cui, Tao Li, Qingyan Liu, Yi Hu
Format: Article
Language:English
Published: BMC 2023-01-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-023-02312-y
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author Xuan Zheng
Shuai Mu
Lijie Wang
Haitao Tao
Di Huang
Ziwei Huang
Xiaoyan Li
Pengfei Cui
Tao Li
Qingyan Liu
Yi Hu
author_facet Xuan Zheng
Shuai Mu
Lijie Wang
Haitao Tao
Di Huang
Ziwei Huang
Xiaoyan Li
Pengfei Cui
Tao Li
Qingyan Liu
Yi Hu
author_sort Xuan Zheng
collection DOAJ
description Abstract Background Patients with pulmonary large cell carcinoma (LCC) have a high incidence of synchronous brain metastases (SBM) and a poor prognosis. Our study was to evaluate the predictive and prognostic value of the clinical characteristics of pulmonary LCC patients with SBM at initial diagnosis by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Methods LCC patients, diagnosed from 2010 to 2019, were identified from the latest SEER database which was released in April 2022. Logistic regression and Cox regression were used to identify the predictive and prognostic factors for LCC patients with SBM. Propensity score matching (PSM) and Kaplan–Meier analyses were applied to assess different therapy modalities. Results A total of 1375 LCC patients were enrolled in this study and 216 (15.7%) of them had SBM at the initial diagnosis. The median overall survival (OS) of LCC patients with SBM was 4 months. Multivariate Cox regression identified age 60–79 (OR 0.57; 95% CI 0.41–0.78; p < 0.001), age ≥ 80 (OR 0.23; 95% CI 0.12–0.45; p < 0.001) and bone metastases (OR 1.75; 95% CI 1.22–2.51; p < 0.001) as significant independent predictors for developing SBM. Multivariable Cox regression revealed that age 60–79, T stage, bone metastases and chemotherapy were independent prognostic factor for OS. The surgery combined with chemotherapy and radiotherapy group, in which all patients were N0 stage and had no other site-specific metastases, exhibited the best median OS of 15 months. Conclusions LCC patients with age < 60 or bone metastases were more likely to have SBM at initial diagnosis. Age, T stage, bone metastases and chemotherapy were independent prognostic factors for OS of LCC patients with SBM. Highly selected patients might achieve the best survival benefit from surgery combined with chemotherapy and radiotherapy.
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spelling doaj.art-20d9b9b52d924d89ba431abc4f70744a2023-01-15T12:03:35ZengBMCBMC Pulmonary Medicine1471-24662023-01-0123111110.1186/s12890-023-02312-yFactors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based studyXuan Zheng0Shuai Mu1Lijie Wang2Haitao Tao3Di Huang4Ziwei Huang5Xiaoyan Li6Pengfei Cui7Tao Li8Qingyan Liu9Yi Hu10Medical School of Chinese PLADepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalDepartment of Oncology, The First Medical Center of PLA General HospitalAbstract Background Patients with pulmonary large cell carcinoma (LCC) have a high incidence of synchronous brain metastases (SBM) and a poor prognosis. Our study was to evaluate the predictive and prognostic value of the clinical characteristics of pulmonary LCC patients with SBM at initial diagnosis by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Methods LCC patients, diagnosed from 2010 to 2019, were identified from the latest SEER database which was released in April 2022. Logistic regression and Cox regression were used to identify the predictive and prognostic factors for LCC patients with SBM. Propensity score matching (PSM) and Kaplan–Meier analyses were applied to assess different therapy modalities. Results A total of 1375 LCC patients were enrolled in this study and 216 (15.7%) of them had SBM at the initial diagnosis. The median overall survival (OS) of LCC patients with SBM was 4 months. Multivariate Cox regression identified age 60–79 (OR 0.57; 95% CI 0.41–0.78; p < 0.001), age ≥ 80 (OR 0.23; 95% CI 0.12–0.45; p < 0.001) and bone metastases (OR 1.75; 95% CI 1.22–2.51; p < 0.001) as significant independent predictors for developing SBM. Multivariable Cox regression revealed that age 60–79, T stage, bone metastases and chemotherapy were independent prognostic factor for OS. The surgery combined with chemotherapy and radiotherapy group, in which all patients were N0 stage and had no other site-specific metastases, exhibited the best median OS of 15 months. Conclusions LCC patients with age < 60 or bone metastases were more likely to have SBM at initial diagnosis. Age, T stage, bone metastases and chemotherapy were independent prognostic factors for OS of LCC patients with SBM. Highly selected patients might achieve the best survival benefit from surgery combined with chemotherapy and radiotherapy.https://doi.org/10.1186/s12890-023-02312-yLarge cell carcinomaSynchronous brain metastasesPrognosisRisk factorsSEER
spellingShingle Xuan Zheng
Shuai Mu
Lijie Wang
Haitao Tao
Di Huang
Ziwei Huang
Xiaoyan Li
Pengfei Cui
Tao Li
Qingyan Liu
Yi Hu
Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
BMC Pulmonary Medicine
Large cell carcinoma
Synchronous brain metastases
Prognosis
Risk factors
SEER
title Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
title_full Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
title_fullStr Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
title_full_unstemmed Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
title_short Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study
title_sort factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients a population based study
topic Large cell carcinoma
Synchronous brain metastases
Prognosis
Risk factors
SEER
url https://doi.org/10.1186/s12890-023-02312-y
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