Final diagnosis of malignancy and clinical features of patients presenting with metastases

AIM: Cancer metastasis is one of the main causes of cancer mortality. In metastatic patients who have not yet been diagnosed with malignancy, the diagnosis of primary malignancy can often be difficult and the initiation of cancer treatment may be delayed. The aim of this study was to determine the characteristics and possible predictive parameters for the diagnosis of primary malignancy by analyzing the clinical data and pathologic diagnoses of patients hospitalized with metastasis. MATERIALS AND METHODS: In this retrospective study, 280 patients who were admitted to the Internal Medicine Clinic of Sakarya University Training and Research Hospital between 01.06.2020-31.10.2023 with the finding of metastasis without a known diagnosis of malignancy were included. Data were obtained by examining the hospital records. The admission symptoms and findings, clinical conditions, comorbidities, laboratory parameters, imaging findings and the final malignancy diagnosis were recorded and analyzed. RESULTS: Of the patients in our study, 112(40%) were female and 168(60%) were male. The most commonly diagnosed malignancies were lung cancer (64 patients), gastric cancer (39 patients), colorectal cancer (37 patients) and pancreatic cancer (37 patients). When the most common malignancies were compared with others, predictive parameters for lung cancer were found to be smoking, hemoglobin value, shortness of breath, presence of brain metastasis and absence of diabetes (p<0.05). Predictive parameters for gastric cancer were low hemoglobin, low MCV, low albumin, sodium level and weight loss (p<0.05). Predictive parameters for colorectal cancer were MCV, liver metastasis and gastrointestinal bleeding (p<0.05). CONCLUSION: The parameters that predict the diagnosis of lung cancer in patients with evidence of metastasis are smoking, hemoglobin value, shortness of breath, brain metastasis, and absence of diabetes. Low hemoglobin, low MCV, low albumin, and weight loss are predictive of gastric cancer. Colorectal cancer should be considered in patients with liver metastases and gastrointestinal bleeding.