Comprehensive evaluation of risk factors for LNM and distant metastasis in patients with NSCLC

Metastasis in non-small cell lung cancer (NSCLC) significantly impacts patient recurrence and survival outcomes. Despite its importance, the factors influencing NSCLC metastasis are not fully understood. This study aimed to explore the association between demographic factors, gene mutation status, and EGFR exon mutation status with NSCLC metastasis, utilizing data from a large cohort of NSCLC patients. This study included a cohort of 1,217 NSCLC patients who received treatment at the First Affiliated Hospital of Chongqing Medical University between December 2019 and November 2023. Comprehensive demographic and clinicopathological data were collected. Mutation status in 9 driver genes and 7 EGFR exon sites were identified. Chi-square or Fisher's exact tests were utilized to examine the associations between these factors and NSCLC metastasis. Logistic regression analysis was conducted to determine the factors influencing metastasis. Among the 1,217 NSCLC patients, 536 (44.0%) experienced lymph node metastasis, and 426 (35.0%) had distant metastasis. A history of smoking emerged as an independent risk factor for lymph node metastasis (OR = 1.79, P = 0.01), with higher T stages correlating with an increased risk of lymph node involvement. Compared to squamous cell carcinoma, adenocarcinoma (OR = 1.95, P < 0.01) and other histological subtypes (OR = 3.62, P < 0.01) were identified as independent risk factors for distant metastasis. RET gene mutation (Mutant vs. Wild-type) was an independent risk factor for distant metastasis (OR = 3.05, P = 0.01). After adjusting for various factors, the Exon 21-L858R mutation (Mutant vs. Wild-type) was independently associated with a lower risk of lymph node metastasis (OR = 0.55, P = 0.002).