Objective: Lung cancer is a leading cause of cancer-related mortality, primarily due to its high metastatic potential, particularly to the brain and bones. Brain metastases significantly challenge clinical management, impacting treatment efficacy and patient survival, while bone metastases cause severe complications such as pathological fractures and hypercalcemia. Understanding the clinico-pathological factors influencing these metastases is essential for improving patient outcomes.

Materials and Methods: This study examined a cohort of 158 patients with primary lung cancer treated at the Cheikh Zaid International University Hospital in Rabat, Morocco. Clinical data, including demographic information, smoking status, and histological and molecular characteristics, were collected. The incidences of bone and brain metastases were analyzed. Statistical analysis was performed using Excel and Jamovi software, with qualitative variables expressed as frequencies and quantitative variables as central tendencies. Associations between variables were evaluated using Chi-square and Fisher’s exact tests, with a significance threshold set at p < 0.05.

Results: Bone metastases were identified in 31 patients (19.6%) via bone scintigraphy, while brain metastases were confirmed in 29 patients (18.4%) through cerebral MRI. No significant differences were observed between males and females or among different age groups. However, smoking was significantly associated with bone metastases (p = 0.034), with smokers exhibiting a higher incidence. A significant association was found between brain metastases and the adenocarcinoma histological subtype (p = 0.001), indicating that specific tumor characteristics influence metastatic patterns. No significant correlation was observed between molecular status and the occurrence of metastases.

Conclusions: This study underscores the importance of clinico-pathological factors in lung cancer metastasis. Smoking is significantly correlated with bone metastases, while adenocarcinoma is closely linked with brain metastases. These findings highlight the need for personalized management strategies and improved data documentation to enhance clinical care.