WCLC 2025 - Posters & ePosters-P2.05.11 Prognostic Impact of Organ-Specific Metastasis in Non-Small Cell Lung Cancer

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This retrospective cohort study investigated the prognostic significance of organ-specific metastases in stage IV non-small cell lung cancer (NSCLC) using data from 3,165 patients registered in the Korean Central Cancer Registry (2014-2018). Patients were classified per the 9th edition TNM staging into M1b (single-organ, single metastasis), M1c1 (multiple metastases within a single organ), and M1c2 (multiple organ metastases). While median overall survival (OS) was longest in M1b (8.0 months), followed by M1c1 (6.0 months) and shortest in M1c2 (5.9 months), survival varied significantly depending on the metastatic organ involved. Notably, metastases to the liver, adrenal glands, and uncommon sites predicted markedly poorer survival even among single-organ metastasis patients (M1b), some of whom had worse OS than those with multiple organ metastases (M1c2). These findings challenge the current TNM M category’s prognostic hierarchy, which is primarily based on metastatic burden rather than metastatic site. The study concludes that incorporating organ-specific metastasis into staging systems and prognostic models could enhance risk stratification and enable more personalized treatment decisions in stage IV NSCLC. Future research directions include large-scale genomic analyses to identify molecular signatures predictive of metastasis to adverse-prognosis organs and validation of findings in the context of immunotherapy, as therapeutic outcomes might differ by metastatic site. This study emphasizes the need to refine the M category beyond metastatic quantity to include metastatic organ impact, potentially transforming prognosis and therapy guidance in advanced NSCLC.

Asset Subtitle

Woo Kyung Ryu

Meta Tag

Speaker Woo Kyung Ryu

Topic Pulmonology and Staging

Keywords

non-small cell lung cancer

stage IV NSCLC

organ-specific metastases

prognostic significance

TNM staging M category

overall survival

single-organ metastasis

multiple organ metastases

Korean Central Cancer Registry

personalized treatment