Survival in Synchronous vs Single Lung Cancer

• Published in: Chest Vol. 118; no. 4; pp. 952 - 958
• Main Authors: van Rens, Marcel Th. M., Zanen, Pieter, Brutel de la Rivière, Aart, Elbers, Hans R.J., van Swieten, Henry A., van den Bosch, Jules M.M.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2000; American College of Chest Physicians
• Subjects: lung neoplasm; multiple primary neoplasm; neoplasm staging; non-small cell lung carcinoma; prognosis; pulmonary surgical procedures; survival; pulmonary surgical procedures; neoplasm staging; NSCLC; lung neoplasm; CI; multiple primary neoplasm; survival; non-small cell lung carcinoma; prognosis
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.118.4.952

To define prognostic parameters for patientswith synchronous non-small cell lung cancer (NSCLC). Retrospective study of period from 1970 through1997. Patients with a single (n = 2,764)and synchronous NSCLC (n = 85) who underwent pulmonaryresection. All tumors were classifiedpostsurgically, and the tumors of the patients with synchronous lungcancer were staged separately. The most advanced tumor was used forcomparison. Actuarial survival time was estimated, and risk factorsinfluencing survival were evaluated. Patients who died within 30 daysof surgery were excluded. Five-year survival for single NSCLC was 41% and for synchronous lungcancer it was 19%. The relative risk of death for patients withsynchronous lung cancer was 1.75, compared to that for patients withsingle lung cancer. The most advanced tumor in synchronous cancer was asignificant predictor of survival (p < 0.005). The survival of patients with synchronous lung cancer in which the most advanced tumorswere stage I (n = 40) and stage II (n = 27) was not different fromthat of patients with stage II (n = 834) and stage IIIA (n = 405)single lung cancer, respectively. Thepoorer survival of patients with synchronous NSCLC is confirmed andquantified. The stage of the most advanced tumor was the best predictorof prognosis. The prognosis of patients with synchronous NSCLCresembles the prognosis of patients with a single lung cancer of ahigher stage. Upstaging in synchronous lung cancer is recommended onthe basis of these observations.