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Table 2 Cox regression for analyzing the mortality among lung metastasis patients in colorectal cancer (diagnosed 2010–2015)

From: Homogeneous and heterogeneous risk and prognostic factors for lung metastasis in colorectal cancer patients

Subject characteristics No. of CRC patients with LM (N = 8867) Survival, median (95% CI, month) Univariable analysis Multivariable analysisa
Overall Deceased (rate, %) HR [95% CI] P value HR [95% CI] P-value
Age(years)        
 ≤ 50 1313 1007 (76.7) 18 (16.7–19.3) 1 (Reference) 1.00 1 (Reference) 1.00
51–60 2115 1698 (80.3) 14 (13.0–15.0) 1.18 (1.09–1.27)  < 0.001 1.14 (1.05–1.23) 0.001
61–70 2353 1937 (82.3) 11 (10.2–11.9) 1.32 (1.22–1.42)  < 0.001 1.31 (1.21–1.41)  < 0.001
71–80 1745 1549 (88.8) 6 (5.3–6.8) 1.76 (1.62–1.90)  < 0.001 1.82 (1.68–1.98)  < 0.001
81–90 1121 1062 (94.7) 2 (1.7–2.3) 2.69 (2.46–2.93)  < 0.001 2.72 (2.48–2.98)  < 0.001
 ≥ 91 220 216 (98.2) 1 (0.4–1.6) 3.89 (3.36–4.51)  < 0.001 3.61 (3.09–4.21)  < 0.001
Sex        
Female 4068 3416 (84.0) 9 (8.3–9.7) 1 (Reference) 1.00 - -
Male 4799 4053 (84.5) 10 (9.4–10.6) 0.99 (0.95–1.04) 0.787 - -
Race        
White 6525 5475 (83.9) 10 (9.5–10.6) 1 (Reference) 1.00 1 (Reference) 1.00
Black 1424 1233 (86.6) 9 (8.0–10.0) 1.08 (1.01–1.15) 0.016 1.06 (1.00–1.13) 0.060
Othersb 902 750 (83.2) 10 (8.6–11.4) 0.98 (0.90–1.05) 0.542 1.02 (0.94–1.10) 0.690
Unknown 16 11 (68.8) 12 (2.7–21.3) 0.96 (0.53–1.73) 0.885 1.14 (0.63–2.07) 0.663
Marital status        
Unmarriedc 4315 3739 (86.7) 8 (7.4–8.6) 1 (Reference) 1.00 1 (Reference) 1.00
Married 4060 3320 (81.8) 13 (12.3–13.7) 0.79 (0.75–0.82)  < 0.001 0.87 (0.83–0.91)  < 0.001
Unknown 492 410 (83.3) 8 (6.0–10.0) 0.87 (0.78–0.96) 0.005 0.92 (0.83–1.02) 0.119
Insurance status        
Insured 6763 5665 (83.8) 10 (9.5–10.5) 1 (Reference) 1.00 1 (Reference) 1.00
Uninsured 1598 1376 (86.1) 9 (8.1–9.9) 1.10 (1.00–1.21) 0.058 1.24 (1.16–1.32)  < 0.001
Any Medic aid 506 428 (84.6) 9 (7.1–10.9) 1.11 (1.05–1.18) 0.001 1.35 (1.22–1.49)  < 0.001
Site        
Right colon 2617 2309 (88.2) 7 (6.3–7.7) 1 (Reference) 1.00 1 (Reference) 1.00
Left colon 2986 2435 (81.6) 12 (11.1–12.9) 0.76 (0.72–0.81)  < 0.001 0.82 (0.77–0.87)  < 0.001
Rectum 2399 1922 (80.1) 14 (13.1–15.0) 0.69 (0.64–0.73)  < 0.001 0.68 (0.64–0.73)  < 0.001
Unknown 865 803 (92.8) 2 (1.5–2.5) 1.51 (1.39–1.63)  < 0.001 1.11 (1.02–1.21) 0.018
Histological grade        
Grade I 356 280 (78.7) 14 (11.1–16.9) 1 (Reference) 1.00 1 (Reference) 1.00
Grade II 4050 3202 (79.1) 15 (14.2–15.8) 0.99 (0.87–1.11) 0.810 1.08 (0.95–1.22) 0.244
Grade III 1167 1031 (88.4) 7 (6.1–7.9) 1.49 (1.31–1.71)  < 0.001 1.58 (1.38–1.81)  < 0.001
Grade IV 195 166 (85.1) 8 (5.6–10.4) 1.34 (1.11–1.63) 0.003 1.51 (1.24–1.83)  < 0.001
Unknown 3099 2790 (90.0) 5 (4.5–5.5) 1.78 (1.57–2.01)  < 0.001 1.32 (1.16–1.49)  < 0.001
Lymphatic metastasis        
N0 3021 2542 (84.1) 8 (7.2–8.8) 1 (Reference) 1.00 1 (Reference) 1.00
N1 2938 2388 (81.3) 12 (11.1–12.9) 0.85 (0.81–0.90)  < 0.001 1.02 (0.96–1.08) 0.485
N2 1315 1078 (82.0) 14 (12.7–15.3) 0.79 (0.74–0.85)  < 0.001 1.17 (1.07–1.27)  < 0.001
Unknown 1593 1461 (91.7) 8 (7.2–8.8) 1.37 (1.28–1.46)  < 0.001 1.07 (1.00–1.14) 0.068
T stage        
T1 1052 920 (87.5) 8 (6.7–9.3) 1 (Reference) 1.00 1 (Reference) 1.00
T2 151 114 (75.5) 19 (14.2–23.8) 0.48 (0.37–0.63)  < 0.001 0.78 (0.60–1.02) 0.071
T3 2285 1717 (75.1) 19 (17.9–20.1) 0.75 (0.69–0.82)  < 0.001 0.93 (0.85–1.02) 0.118
T4 1875 1572 (83.8) 11 (10.1–11.9) 0.83 (0.75–0.92)  < 0.001 1.07 (0.96–1.18) 0.223
Unknown 3504 3146 (89.8) 5 (4.5–5.5) 1.23 (1.13–1.35)  < 0.001 1.01 (0.92–1.11) 0.792
CEA        
Negative 745 543 (72.9) 20 (17.7–22.3) 1 (Reference) 1.00 1 (Reference) 1.00
Positive 5282 4477 (84.8) 10 (9.5–10.6) 1.62 (1.48–1.77)  < 0.001 1.27 (1.16–1.39)  < 0.001
Unknown 2840 2449 (86.2) 8 (7.2–8.8) 1.73 (1.57–1.89)  < 0.001 1.34 (1.21–1.47)  < 0.001
Liver metastasis        
No 2406 1759 (73.1) 17 (15.8–18.2) 1 (Reference) 1.00 1 (Reference) 1.00
Yes 6350 5612 (88.4) 8 (7.5–8.5) 1.75 (1.66–1.85)  < 0.001 1.64 (1.55–1.73)  < 0.001
Unknown 111 98 (88.3) 8 (3.5–12.5) 1.52 (1.24–1.86)  < 0.001 1.21 (0.97–1.50) 0.098
Bone metastasis        
No 7663 6357 (83.0) 11 (10.5–11.5) 1 (Reference) 1.00 1 (Reference) 1.00
Yes 899 829 (92.2) 5 (4.2–5.8) 1.55 (1.45–1.67)  < 0.001 1.38 (1.28–1.48)  < 0.001
Unknown 305 283 (92.8) 4 (2.6–5.4) 1.47 (1.30–1.65)  < 0.001 1.32 (1.09–1.60) 0.004
Brain metastasis        
No 8267 6921 (83.7) 10 (9.5–10.5) 1 (Reference) 1.00 1 (Reference) 1.00
Yes 248 227 (91.5) 3 (2.0–4.0) 1.68 (1.47–1.92)  < 0.001 1.51 (1.32–1.73)  < 0.001
Unknown 352 321 (91.2) 5 (3.8–6.3) 1.36 (1.22–1.52)  < 0.001 0.86 (0.72–1.03) 0.103
Surg (pri)        
No 5956 5286 (88.8) 7 (6.6–7.4) 1 (Reference) 1.00 1 (Reference) 1.00
Yes 2878 2157 (75.0) 19 (17.9–20.1) 0.51 (0.49–0.54)  < 0.001 0.56 (0.52–0.60)  < 0.001
Unknown 33 26 (78.8) 12 (3.5–20.5) 0.59 (0.40–0.87) 0.007 0.45 (0.31–0.67)  < 0.001
  1. CEA, carcinoembryonic antigen; CRC, colorectal cancer; CI, confidence interval; HR, hazard ratio; LM, lung metastasis; NA, not available; Surg(pri), surgical treatments of primary site
  2. aAdjusted for age, race, marital status, insurance status, site, histological grade, lymphatic metastasis, T stage, CEA, liver metastasis, bone metastasis, and brain metastasis
  3. bIncludes American Indian/Alaska Native and Asian or Pacific Islander
  4. cIncludes single, separated, widowed, and divorced