Clinical Characteristics of Miliary Pulmonary Metastases in Non-small Cell Lung Cancer = Clinical Characteristics of Miliary Pulmonary Metastases in Non-small Cell Lung Cancer

다국어 초록 (Multilingual Abstract)

Purpose
The prognosis of miliary pulmonary metastases (MPM), which are characterized as randomly disseminated, innumerable, and small metastatic nodules, has been considered as being poor. The purpose of this study is to evaluate the clinical characteristics and survival of MPM in patients with non-small cell lung cancer (NSCLC).
Methods
This retrospective study included NSCLC patients with MPM and non-miliary pulmonary metastases (NMPM) detected during staging evaluation between 2000 and 2020. MPM are defined as the presence of bilaterally distributed > 16 metastatic pulmonary nodules (<1cm in diameter), and NMPM are defined as the presence of ￡ 15 metastatic pulmonary nodules regardless of size. Baseline characteristics, genetic alterations and overall survival (OS) rates were compared between the two groups.
Results
Twenty-six subjects with MPM and 78 subjects with NMPM were analyzed. The MPM group showed higher tendency in the proportions of never smoker (69% vs 49%, p = 0.187) and adenocarcinoma histology (100% vs 81%, p = 0.054) compared with the NPMM group. The frequency of EGFR mutation was significantly higher in the MPM group (58%) than in the NMPM group (24%; p = 0.006). There was no significant difference in OS rates between the two groups (p = 0.893). However, among the MPM group, there was no significant difference in clinical characteristics and OS between <5mm vs ³5mm groups.
Conclusion
MPM in NSCLC were significantly related to the EGFR mutation. The OS rate of MPM group was not inferior to that of NMPM group. The presence of EGFR mutation should be thoroughly evaluated for NSCLC patients with initial presentation of MPM.