Objective The aim of this study was to explore the effect of different organ metastasis on the prognosis of non-small cell lung cancer (NSCLC). Methods Patients with distant metastatic NSCLC were selected from Surveillance, Epidemiology, and End Results database during 2016 to 2019. The incidence of different organ metastasis and their association with clinicopathological factors were explored. Overall survival (OS) and lung cancer-specific survival (LCSS) for metastatic NSCLC were calculated, and multivariate Cox regression analysis was performed with a nomogram for OS being constructed based on Cox regression. Results Total 26,210 patients with distant metastatic NSCLC were included in this study. Around 48.9% of the metastatic NSCLC were multiple-organ metastasis and bone was the most commonly involved organ (44.4%). For patients with single-organ metastasis, the prognosis for lung or distant lymph nodes (LNs) metastasis was better than others (with median OS of 15 and 16 months for lung and distant LNs metastasis, respectively), and liver metastasis resulted in the worst prognosis with median OS of 8 months. A nomogram was constructed to visualize Cox regression model, along with the receiver operating characteristic (ROC) curve demonstrated good discrimination for the predictive model with 1- and 2-year area under the curve of ROC of 0.687 and 0.702, respectively. Conclusion The prognosis of NSCLC patients with distant metastasis was poor. Liver metastasis results in the worst prognosis among the single-organ metastasis. The nomogram developed based on the Cox regression model has provided a useful tool to estimate the probability of OS of the metastatic NSCLC.

中文翻译：

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不同器官转移的发生率及对NSCLC预后的影响

目的探讨不同器官转移对非小细胞肺癌（NSCLC）预后的影响。方法从2016年至2019年监测、流行病学和最终结果数据库中选择远处转移NSCLC患者，探讨不同器官转移的发生率及其与临床病理因素的关系。计算转移性 NSCLC 的总生存期 (OS) 和肺癌特异性生存期 (LCSS)，并进行多变量 Cox 回归分析，并根据 Cox 回归构建 OS 列线图。结果本研究共纳入26,210例远处转移NSCLC患者。约 48.9% 的转移性 NSCLC 为多器官转移，骨是最常受累的器官 (44.4%)。对于单器官转移患者，肺转移或远处淋巴结转移的预后优于其他患者（肺转移和远处淋巴结转移的中位 OS 分别为 15 个月和 16 个月），肝转移最差预后中位 OS 为 8 个月。构建列线图来可视化 Cox 回归模型，以及受试者工作特征 (ROC) 曲线，证明预测模型具有良好的辨别力，ROC 曲线下的 1 年和 2 年面积分别为 0.687 和 0.702。结论 发生远处转移的NSCLC患者预后较差。在单器官转移中，肝转移的预后最差。基于Cox回归模型开发的列线图为估计转移性NSCLC的OS概率提供了有用的工具。