Author of

• 20154

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  P1.05 - Early Stage NSCLC (ID 691)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22638

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    P1.05-016 - The Prognosticator in Synchronous Multiple Primary Lung Cancer: A Comprehensive Analysis of 438 Cases (ID 9473)

    09:30 - 09:30  |  Presenting Author(s): Yi Liu
    • Abstract

    Background:
    Synchronous multiple primary lung cancers (sMPLC) demonstrate good outcome if metastatic disease was absent. However, the prognostic factors vary across published reports.
    
    Method:
    Patients who met Martini & Melamed criteria of sMPLC were included for this study. Patients with small cell lung cancer, carcinoid tumor, neuroendocrine, incomplete resection or insufficient follow-up were excluded. Overall survival (OS) was estimated using the Kaplan-Meier method, cause-specific mortality analysis was performed with competing risks analysis; factors associated with survival outcome were evaluated using log-rank test and Cox proportional hazards models. Propensity score was taken to match the variables between sMPLC and sPLC with a ratio of 1:4.
    
    Result:
    A total of 438 patients met inclusion criteria for the study. The mean follow-up time was 6.3 years (1-22.9), with a 5-year OS rate of 59.48%. Squamous cell carcinoma (SQC) was a sole histology in 50 patients (Pure SQC group); SQC with other cell type in 59 patients (SQC-other group); no SQC in 329 patients (Non-SQC group). The 5-year OS rate of pure SQC group, SQC-other groups and Non-SQC group were 44.7%, 33.0% and 66.8% (p<0. 001) in univariate analyses. In multivariable analyses the SQC present as an independent poor predictor, the hazard ratio (HR) for pure SQC group was 1.39 (95% CI, 0.97-2.0, P=0.004) and SQC-other group was 1.82, (95% CI, 1.27-2.61, P=0.004) compared to Non-SQC group. Pure SQC group and SQC-other group were both with poorer survival than Non-SQC group in cause-specific mortality analysis. The sublobe resection (n=233) and pneumonectomy (n=14) shows worse outcome than pure lobectomy (n=174) with 5-year OS rate were 53.8%, 45.9% and 70.5%. The HR for sublobe resection and pneumonectomy in multivariate analyses were 1.41 (95% CI, 1.07-1.89, P=0.002) and 1.91 (95% CI, 1.0-3.7). The outcome of surgical T1-4N0M0 sMPLC with solo cell type (n=339) was worse than well-matched sPLC (n=1356), with a 5-year OS rate were 65% and 68.2% (P=0.05); the 5-year OS rate of sMPLC with different cell type and well-matched sPLC (cell type match to more aggressive one) were similar (41.7 vs. 52.7, P=0.36). The other significant prognostic factors include sex, age, highest tumor stage, highest lymph node stage and smoke status.
    
    Conclusion:
    The presence of SQC in sMPLC represents the poor outcome; The sublobe resection and pneumonectomy decease the survival of sMPLC patients; For those surgical T1-4N0M0 patients, the outcome was similar with well-matched sPLC; Studies with bigger size were needed to further confirm the findings.