Abstract
The prognostic indicators for synchronous multiple primary non-small cell lung cancer (NSCLC) vary across reports. In present study, the prognostic factors for the patients with synchronous multiple primary NSCLC were analyzed in a large cohort. A total of 285 patients with synchronous multiple primary NSCLC who underwent radical surgical resection and with complete follow-up information were included in this study. The Kaplan-Meier method were used for survival analysis, Cox proportional hazards regression models were used for risk factors evaluation. Among them, 94 (33.0%) patients had bilateral tumors and 51 (17.9%) had multiple (≥3) tumors. The 5-year disease-free survival (DFS) and overall survival (OS) rate was 58.7% and 77.6%, respectively. Univariate analysis identified parameters conferring shorter OS including male gender, symptomatic disease, negative family history, large maximal tumor size, not all adenocarcinomas, advanced highest T stage, and lymph node involvement. Multivariate analysis showed that male gender (p = 0.020), symptomatic disease (p = 0.017), and lymph node involvement (p < 0.001) were independent adverse prognosticators. For patients with multiple adenocarcinomas, the 5-year DFS and OS rate was 59.6% and 82.4%, respectively. The subtypes other than lepidic predominant (p < 0.001) and lymph node involvement (p = 0.002) were the independent unfavorable prognosticators. In conclusion, we identified independent prognosticators which will provide the valuable clues for postoperative management of patients with synchronous multiple primary NSCLC.
Highlights
In clinical practice, a large number of multiple tumor nodules are demonstrated as synchronous multiple primary lung cancers (SMPLCs) as a result of the worldwide use of high resolution imaging systems
290 patients met the modified criteria of Martini and Melamed and were classified with SMPLC. 5 were excluded from data analysis, including 1 patient who died during the perioperative period, 1 who died 45 days postoperatively of respiratory failure after the second operation (0.69%), 2 patients who died from non-cancer-related reasons (1 from acute myocardial infarction and 1 from cerebrovascular accident), and 1 patient who was lost to follow-up
In a retrospective series of 285 patients who underwent surgery for synchronous multiple primary non-small cell lung cancer (NSCLC), the 5-year disease-free survival (DFS) and overall survival (OS) rate was 58.7% and 77.6%, respectively, which are comparable to previous reports[10,11,12,13,14,15]
Summary
A large number of multiple tumor nodules are demonstrated as synchronous multiple primary lung cancers (SMPLCs) as a result of the worldwide use of high resolution imaging systems. In 1975, Martini and Melamed initially proposed diagnostic criteria to discriminate synchronous and metachronous multiple lung cancers from intrapulmonary metastases in 50 patients[4]. This diagnostic algorithm was modified and optimized as more information, including genetic and molecular analyses, became available, and have improved clinical accuracy and mitigated the problems of differential diagnosis. In a large cohort of patients, we analyzed surgical outcomes of synchronous multiple primary non-small cell lung cancer (NSCLC) to investigate the prognostic values of various clinical parameters for long-term survival. The present study, to our knowledge, is the largest investigation on clinical outcome of patients treated with surgery for synchronous multiple primary NSCLC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
