Cutaneous metastasis as a initial presentation in advanced non-small cell lung cancer and its poor survival prognosis

Cutaneous metastases in primary advanced non-small cell lung cancer (NSCLC) rarely occur in comparison with other site involvement. The incidence of cutaneous metastases and its prognosis is not well known. Data from a 2,130 patients with advanced NSCLC were analyzed, in order to assess the incidence and survival prognosis of cutaneous metastases in primary advanced NSCLC.

The clinical data of 2,130 patients with advanced NSCLC who were admitted to Zhejiang cancer Hospital from January 1998 to December 2007 were retrospectively analyzed. Data pertaining to their presentation, diagnosis treatment, pathology, follow-up, and clinical course were documented. Clinical characteristics were investigated based on the clinical and pathologic records. All of the cutaneous metastases were confirmed by cytology or biopsy. Survival analysis was made by Kaplan-Meier method. The Cox regression model was performed to analyze the relationship between the influential factors and the overall survival.

Among the 2,130 advanced NSCLC patients as initial diagnosis, 60 (2.8 %) demonstrated abnormally cutaneous metastases. Fifteen patients with only cutaneous metastases, forty-five subjects combined with other site metastasis. There were 56 patients who received chemotherapy, and the first-line disease control rate was 33.9 %, the median free progression survival time was 1.9 months. There were significant differences in overall survival between cutaneous metastases and non-cutaneous metastases arms (3.9 vs. 10.0 months, P < 0.001). Multivariate analyses revealed that performance status and chemotherapy efficacy statistically associated with overall survival.

This retrospective study indicated that 2.8 % of advanced NSCLC patients showed cutaneous metastases as an initial presentation. Cutaneous metastases of lung cancer are of poor prognosis.