In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 7024-7024
Abstract:
7024 Background: Surgical resection is a treatment option for patients with multiple primary lung cancers. However, for synchronous disease, it is often difficult to differentiate this condition from metastatic disease, especially when cancers are distributed in multiple lobes or in both lungs. Some people believe that surgery should be avoided when patients have bilateral cancers or when all cancers have the same histology. To date, however, available evidences are limited by small sample size. Methods: Studies (published 2008-2011) of curative resection for patients with synchronous ( 〈 2-year interval) multiple lung cancers located in ≥ 2 lobes, but without radiographic evidence of distant metastasis, were identified from literature. Corresponding authors were contacted and individual patient data were obtained. Patients with multiple cancers, but localized only to one lobe, were not included. Databases were pooled and multi-variable Cox Proportional Hazard models were fit to adjust for confounders. Results: There were 467 patients included from 6 studies. Median overall survival was 52.0 months (95% CI: 45.6-63.7). Postoperative (30-day) mortality rate was 1.9%. In a multivariable model, study site or having pneumonectomy did not independently impact on survival. However, age, gender, nodal stage, tumor location, and histological similarity were independent predictors of survival. Advanced age increased mortality (p=0.012). Male sex increased mortality compared with female: HR 1.64 (95% CI: 1.23-2.19, p=0.0008). N2 or N1 increased mortality over N0: HR 1.85 (95% CI 1.29-2.66, p=0.0008) and 1.97 (1.43-2.73, p=0.0001), respectively. Unilateral location increased mortality over bilateral location: HR 1.62 (95% CI 1.23-2.13, p=0.0002). Different histology increased mortality over similar histology: HR 1.45 (95% CI 1.11-1.90, p=0.0069). Conclusions: In this largest multi-institutional database of resected multiple lung cancers of multiple lobes to date, we found no evidence of inferior survival among patients having bilateral cancers or having all cancers with the same histology. In fact, the survival among such patients appears superior to their counterparts.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.7024
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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