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Background Early metastasis is a hallmark of small cell lung cancer (SCLC). However, the mechanisms and resulting patterns of SCLC dissemination are unclear. Our aim was thus to investigate the organ specificity and timing of blood‐borne metastases in a comprehensive large cohort of SCLC patients. Methods In this retrospective non‐interventional cross‐sectional study of 1009 Caucasian SCLC patients, we investigated the correlation between the distinct locations of the primary tumor and metastatic sites. Results The onset of bone (p, In this study, our aim was to examine the organ specificity and timing of blood‐borne metastases in a comprehensive large cohort of Caucasian SCLC patients (n =1009). We report here that the onset of bone, brain, and pericardial metastases are late events, whereas adrenal gland and liver metastases occur earlier during tumor progression. We also show that several metastatic sites, such as bone and liver, and brain and adrenal gland intend to co‐metastasize preferentially. Of note, however, no significant associations were observed with regards to the timing and organ preference of distant metastases when comparing central and peripheral primary tumors.

Background Metastatic lung cancer is a debilitating disease, but with the advances in immunotherapy, therapeutic options have vastly increased. Numerous complete blood count parameters (CBC) have been described as easily accessible biomarkers that might predict response to immunotherapy. However, to date, no comprehensive study has been performed on the longitudinal changes of these parameters during cancer progression. Methods The clinicopathological variables and CBC parameters of 986 advanced stage lung cancer patients were retrospectively analyzed. Blood tests were performed as part of the routine checkup and the results were recorded at the time of the diagnosis of the primary tumor, the diagnosis of brain or bone metastases, and also during the last available follow‐up. Results In the experimental subcohort, 352 and 466 patients were diagnosed with brain and bone metastases, respectively. The control group consisted of 168 patients without clinically detectable or other distant organ metastases. In our longitudinal analyses, we found significantly decreasing absolute lymphocyte count (ALC: P, In our longitudinal analyses, we found significantly decreasing ALC, and significantly increasing ANC levels in advanced‐stage lung cancer patients during disease progression. Interestingly, patients with brain metastases have descending‐ascending PLT trendlines, while patients with bone metastases exhibit ascending‐descending trendlines during disease progression. The current study might help to improve patient selection and treatment strategies for brain and bone metastatic lung cancer patients.