Occult metastases and survival of lung cancer by clinical diagnosis and CT screening: A simulation study
2025

Occult Metastases and Lung Cancer Survival: A Simulation Study

publication Evidence: high

Author Information

Author(s): Chen Xing, Kanhar Ghulam Muhammad, Hu Songli, Wu Chaomin, Chao Guanqun, Jing Mengqi, Zhang Fengjiang, Young Millennia, Kimmel Marek, Chen Liying, Gorlova Olga Y.

Primary Institution: Zhejiang University, Hangzhou, China

Hypothesis

How much can early detection and screening reduce the proportion of occult metastases and benefit NSCLC patients?

Conclusion

Effective screening measures that detect smaller tumors will considerably benefit asymptomatic lung cancer patients.

Supporting Evidence

  • 35.3% of patients diagnosed with stage N0M0 had undetected metastases.
  • 78% of clinically detected Stage I lung cancers with tumor diameter 1–2 cm were true stage N0M0.
  • The probability of occult metastases significantly increases when the primary tumor exceeds 2 cm in diameter.
  • Mortality reduction in screened patients ranged from 15.04% to 18.82% depending on screening frequency.

Takeaway

This study shows that finding lung cancer early can help patients live longer, especially if the tumors are small.

Methodology

The study used mathematical models to simulate lung cancer characteristics and survival based on screening frequency and tumor size.

Limitations

The study cannot model the differential survival benefit of finding tumors of different sizes within the same group.

Participant Demographics

Individuals aged 55–77 with a smoking history of 30 or more pack-years were considered eligible for screening.

Statistical Information

Confidence Interval

95% CI 10.87%±19.50%

Digital Object Identifier (DOI)

10.1371/journal.pone.0313544

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