Therapeutic method for early-stage second primary non-small lung cancer: analysis of a population-based database

Abstract Background Early-stage non-small lung cancer patients may survive long enough to develop second primary lung cancers. However, few studies have accurately described the therapeutic method, evaluation or prognostic factors for long-term survival in this complex clinical scenario. Methods Patients who had first and second primary non-small lung cancer in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were evaluated. Patients were included when their tumors were pathologically diagnosed as non-small lung cancer and in the early-stage (less than 3 cm and with no lymph node metastasis). Therapeutic methods were categorized as lobectomy, sublobectomy or no surgery. The influence of different therapeutic methods on the overall survival rate was compared. Results For the first primary tumor, patients who underwent lobectomy achieved superior survival benefits compared with patients who underwent sublobectomy. For the second primary tumor, long-term survival was similar in patients who underwent lobectomy and those who underwent sublobectomy treatment. The multivariate analysis indicated that age, disease-free time interval, sex, and first and second types of surgery were independent prognostic factors for long-term survival. Our results showed that the 5-year overall survival rate was 91.9% when the disease-free interval exceeded 24 months. Conclusion Lobectomy for the first primary tumor followed by sublobectomy for the second primary tumor may be a beneficial therapeutic method for patients. If the disease-free interval exceeds 24 months, the second primary tumor will have no influence on the natural course for patients diagnosed with a first primary non-small lung cancer.

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Therapeutic method for early-stage second primary non-small lung cancer: analysis of a population-based database

10.21203/rs.3.rs-228267/v1 ◽

2021 ◽

Author(s):

Congcong Chen ◽

Zixiang Wu ◽

Ziheng Wu ◽

Chuanqiang Wu ◽

Qi Wang ◽

...

Keyword(s):

Lung Cancer ◽

Primary Tumor ◽

Early Stage ◽

Second Primary ◽

Term Survival ◽

Long Term Survival ◽

Therapeutic Method ◽

Second Primary Tumor ◽

Disease Free

Abstract Background Early-stage non-small lung cancer patients may survive long enough to develop second primary lung cancers. However, few studies have accurately described the therapeutic method, evaluation or prognostic factors for long-term survival in this complex clinical scenario.Methods Patients who had first and second primary non-small lung cancer in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were evaluated. The patients were included when their tumors were pathologically diagnosed as non-small lung cancer and in the early-stage (less than 3 cm and with no lymph node metastasis). Therapeutic methods were categorized as lobectomy, sublobectomy or no surgery. The influence of different therapeutic methods on the overall survival rate was compared. Results For the first primary tumor, patients who underwent lobectomy achieved superior survival benefits compared with patients who underwent sublobectomy. For the second primary tumor, long-term survival was similar in patients who underwent lobectomy and those who underwent sublobectomy treatment. The multivariate analysis indicated that age, disease-free time interval, sex, first and second type of surgery were independent prognostic factors for long-term survival. Our results showed that the 5-year overall survival rate was 91.9% when the disease-free interval exceeded 24 months.Conclusion Lobectomy for the first primary tumor followed by sublobectomy for the second primary tumor may be a beneficial therapeutic method for patients. If the disease-free interval exceeds 24 months, the second primary tumor will have no influence on the natural course for patients diagnosed with a first primary non-small lung cancer.

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Diagnosis of second primary tumor and long-term survival after single initial triple endoscopy in patients with head and neck cancer

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-013-2768-6 ◽

2013 ◽

Vol 271 (8) ◽

pp. 2285-2292 ◽

Cited By ~ 4

Author(s):

Antonio Vitor Martins Priante ◽

Jefferson Luiz Gross ◽

Claudia Zitron Sztokfisz ◽

Inês Nobuko Nishimoto ◽

Luiz Paulo Kowalski

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Primary Tumor ◽

Second Primary ◽

Term Survival ◽

Long Term Survival ◽

Second Primary Tumor

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Long-term survival and prognostic assessment of resected neuroendocrine lung cancer at early stage

Lung Cancer ◽

10.1016/0169-5002(91)91514-c ◽

1991 ◽

Vol 7 ◽

pp. 46

Author(s):

C. Lequagtle ◽

I. Cataldo ◽

F. Preda ◽

G. Ravasi

Keyword(s):

Lung Cancer ◽

Early Stage ◽

Term Survival ◽

Long Term Survival ◽

Prognostic Assessment

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Comparison of Long-term Survival of Patients With Early-Stage Non–Small Cell Lung Cancer After Surgery vs Stereotactic Body Radiotherapy

JAMA Network Open ◽

10.1001/jamanetworkopen.2019.15724 ◽

2019 ◽

Vol 2 (11) ◽

pp. e1915724

Author(s):

Alexander Chi ◽

Wei Fang ◽

Yeping Sun ◽

Sijin Wen

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Stereotactic Body Radiotherapy ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Long Term Survival

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Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1710068 ◽

2020 ◽

Author(s):

Alex Fourdrain ◽

Patrick Bagan ◽

Olivier Georges ◽

Sophie Lafitte ◽

Florence De Dominicis ◽

...

Keyword(s):

Lung Cancer ◽

Surgical Resection ◽

Primary Lung Cancer ◽

Extent Of Resection ◽

Tumor Stage ◽

Second Primary ◽

Term Survival ◽

Long Term Survival ◽

Lung Cancers

Abstract Background Patients treated surgically for lung cancer may present synchronous or metachronous lung cancers. The aim of this study was to evaluate outcomes after a second contralateral anatomic surgical resection for lung cancer. Methods We performed a retrospective two-center study, based on a prospective indexed database. Included patients were treated surgically by bilateral anatomic surgical resection for a second primary lung cancer. We excluded nonanatomic resections, benign lesions, and ipsilateral second surgical resections. Results Between January 2011 and September 2018, 55 patients underwent contralateral anatomic surgical resections for lung cancer, mostly for metachronous cancers. The first surgical resection was a lobectomy in most cases (45 lobectomies: 81.8%, 9 segmentectomies: 16.4%, and 1 bilobectomy: 1.8%), and a video-assisted thoracic surgery (VATS) procedure was used in 23 cases (41.8%). The mean interval between the operations was 38 months, and lobectomy was less frequent for the second surgical resection (35 lobectomies: 63.6% and 20 segmentectomies: 36.4%), with VATS procedures performed in 41 cases (74.5%). Ninety-day mortality was 10.9% (n = 6), and 3-year survival was 77%. Risk factor analysis identified the number of resected segments during the second intervention or the total number of resected segments, extent of resection (lobectomy vs. segmentectomy), surgical approach (thoracotomy vs. VATS), tumor stage, and nodal involvement as potential prognostic factors for long-term survival. Conclusion A second contralateral anatomic surgical resection for multiple primary lung cancer is possible, with a higher early mortality rate, but acceptable long-term survival, and should be indicated for carefully selected patients.

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Anatomic resection has superior long-term survival compared with wedge resection for second primary lung cancer after prior lobectomy

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa443 ◽

2020 ◽

Author(s):

Mirza Zain Baig ◽

Syed S Razi ◽

Stephanie Stroever ◽

Joanna F Weber ◽

Cliff P Connery ◽

...

Keyword(s):

Lymph Node ◽

Cox Regression ◽

Early Stage ◽

Wedge Resection ◽

Primary Lung Cancer ◽

Second Primary ◽

Anatomic Resection ◽

Term Survival ◽

Long Term Survival

Abstract OBJECTIVES The extent of surgical resection for early-stage second primary lung cancer (SPLC) in patients with a previous lobectomy is unclear. We sought to compare anatomic lung resections (lobectomy and segmentectomy) and wedge resections for small peripheral SPLC using a population-based database. METHODS The Surveillance, Epidemiology and End Results database was queried for all patients with ≤2 cm peripheral SPLC diagnosed between 2004 and 2015 who underwent prior lobectomy for the first primary and surgical resection only for the SPLC. American College of Chest Physicians guidelines were used to classify SPLC. Kaplan–Meier analysis and multivariable Cox regression were used to compare overall survival. RESULTS A total of 356 patients met the inclusion criteria with 203 (57%) treated with wedge resection and 153 (43%) treated with anatomic resection. Significantly better median survival was observed with anatomic resection than with wedge resection using a Kaplan–Meier analysis (124 vs 63 months; P < 0.001). With multivariable Cox regression, improved long-term survival was observed for anatomic resection (hazard ratio: 0.44, confidence interval: 0.27–0.70; P = 0.001). Improvement in survival was demonstrated with wedge resection when lymph node sampling was done. Lastly, we calculated the average treatment effect on the treated with inverse probability weighting for a subgroup of patients and found that those with wedge resection and lymph node sampling had shorter long-term survival times. CONCLUSIONS Anatomic resections may provide better long-term survival than wedge resections for patients with early-stage peripheral SPLC after prior lobectomy. Significant improvement in survival was observed with wedge resection for SPLC when adequate lymph node dissection was performed.

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