Predictors of survival after resections of synchronous lung cancers located in mutiple lobes: A multi-institutional pooled analysis.

Authors

null

Tawee Tanvetyanon

H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL

Tawee Tanvetyanon , David J. Finley , Thomas Fabian , Marc Riquet , Luca Voltolini , William J Fulp , Celalettin Kocaturk , Bernard J. Park , Lary Robinson

Organizations

H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, Memorial Sloan-Kettering Cancer Center, New York, NY, Albany Medical Center, Albany, NY, Georges Pompidou European Hospital, Paris, France, University Hospital of Siena, Siena, Italy, Yedikule Hospital for Chest Disease and Thoracic Surgery, Istanbul, Turkey

Research Funding

No funding sources reported
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.

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Abstract Details

Meeting

2012 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Lung Cancer - Non-small Cell Local-regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Citation

J Clin Oncol 30, 2012 (suppl; abstr 7024)

DOI

10.1200/jco.2012.30.15_suppl.7024

Abstract #

7024

Poster Bd #

16

Abstract Disclosures

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