Endobronchial metastatic disease

Endobronchial metastasis (EM) is rare. Patients with EM are in advanced stages of disease and have poor prognoses. However, some patients have had long-term survival after aggressive treatment.

We retrospectively reviewed the records of 9678 patients who had undergone bronchoscopic procedures. Forty patients were diagnosed as having EM.

The most common site of primary tumors was the head and neck [10 nasopharyngeal carcinomas (NPC), 2 buccal cancers, 2 glossal cancers, 2 laryngeal cancers]. Clinical manifestations included cough (50%), hemoptysis (20%), dyspnea (15%), and absence of respiratory symptoms (15%). The most common findings in chest roentgenograms (CXR) were single masses (40%). The median length of survival for all patients was 12 months (range, 6 to 18 months). The median length of survival in patients whose ages were over 70 years was 1 months and in patients less than 70 years old it was 12 months (range, 7 to 19 months) (p = 0.002). In patients whose EM extent was to the main bronchus, the median length of survival was 1 month (range, 1 to 3 months) and that in those whose EM did not extend to main bronchus was 12 months (range, 11 to 21 months) (p = 0.0004). In patients whose primary tumors were due to head and neck cancer other than NPC, the survival time was 1 month (range, 1 to 11 months), and in others it was 12 months (range, 7 to 19 months) (p = 0.0008).

Three factors contributed to a poor prognosis, including the patient's age being over 70 years, primary tumors due to head and neck cancer other than NPC, and extension of the endobronchial metastatic lesion to the main bronchus.