Objective: To investigate whether age or other factors are determinants of distant metastasis in patients with lung
Study Design: Observational study.
Place and Duration of Study: Department of Nuclear Medicine, Recep Tayyip Erdogan University, Rize, Turkey between
December, 2018 and February, 2019.
Methodology: A total of 152 patients with lung cancer, who underwent positron emission tomography/computed tomography
(PET/CT) for staging, were included in this study. Patients were grouped according to age (>65 and <65 years) and distant
metastasis status. Metastasis localisation of patients was evaluated by PET/CT. Univariate/multivariate regression analyses were
performed to determine risk factors for distant metastasis.
Results: No significant difference was found when the relation of distant metastasis with stage distribution was examined in
both age groups. Distant metastasis rates were significantly higher in female patients than in male patients (p = 0.019) and in
patients with small-cell lung carcinoma (SCLC)-adenocarcinoma than in those with other histopathological subtypes (p <0.001).
Most of the patients in both groups had a stage 4 disease, and bone distant metastasis was the most common in both age
groups. Univariate/multivariate analyses identified that female gender (p = 0.017/p = 0.003), SCLC subtype (p = 0.013/p =
0.008), T3/T4 tumour (p <0.001/p <0.001), and smoking history of >66 pack-years (p = 0.047/p = 0.047) were independent
factors for the presence of distant metastasis.
Conclusion: Although age is not a risk factor for distant metastasis in lung cancer, female gender, T3/4 tumour, SCLC subtype,
and smoking history of >66 pack-years are high-risk factors. PET/CT is recommended as the first-choice imaging technique in
patients with lung cancer indicated for distant metastasis scanning.