[Distribution of lung cancer metastases. I. Combination and frequency of organ metastases]

The distribution of metastatic tumors of 935 lung cancers with blood borne metastases has been analysed. The frequency of affected organs decreased in the following sequence: liver, bone, adrenal, brain, lung, kidney, thyroid gland, pancreas, spleen and heart. In cases with only one metastatic affected organ the frequency of brain and lung metastases is greater than the frequency of liver, bone and adrenal metastases. Especially in cases with two different affected organs the pair combination of liver and bone metastases as well as of brain and adrenal metastases is evident, however, combined brain and bone metastases and brain and liver metastases rarely occur. The distinct pattern of metastatic distribution in the body supports the evidence of the "soil" hypothesis. Seldom affected organs rarely shows a strong metastatic involvement and go hand in hand with many other affected organs. In autopsies the duration of cancer disease is much longer in cases without metastasis or small metastatic involvement than in cases with many affected organs. Therefore, the generalization of metastatic spread mainly depends on the malignancy of tumors and to a less extent on the duration of cancer disease.