Metastatic pattern in non-resectable non-small cell lung cancer

This study describes the metastatic pattern at autopsy in patients with non -resectable non-small cell lung cancer (NSCLC) and evaluates the impact of various pretreatment variables and treatment outcomes on the metastatic spr ead. In eight phase II chemotherapy trials from 1985 through 1993, 337 pati ents were treated and 51 autopsies were performed (autopsy rate 15%). The m ale/female ratio was 31/20, median age 56 years (range 36-71), response rar e to chemotherapy 8%, and median survival 88 days (range 3-899). Histologic types included adenocarcinoma, 31 cases (60%), squamous cell carcinoma, 9 cases (18%), large cell carcinoma, 9 cases (18%), and unclassified NSCLC, 2 cases (4%). Patients who were autopsied had a shorter median survival than patients without autopsy (p = 0.002, log-rank test). Most commonly involve d metastatic sites found ar autopsy were mediastinal lymph nodes (84%), ple ura (51%), liver (47%), bone (34%). brain (32%), pericardium (29%), adrenal s (29%) The median number of involved organs was 5 (range 1-16), with a med ian of 3 intrathoracic sites (range 1-8) and 2 extrathoracic sites (range 0 -11). Patients who initially had metastatic NSCLC also had significantly mo re metastatic sites at autopsy both extrathoracic (p = 0.004) and totally ( p = 0.03) compared to patients with locally advanced disease. No other rela tion to pretreatment variables was found.