Survival comparison of right and left side non‐small cell lung cancer in stage I–IIIA patients: A Surveillance Epidemiology and End Results (SEER) analysis

Jia, Bo; Zheng, Qiwen; Qi, Xinmeng; Zhao, Jun; Wu, Meina; An, Tongtong; Wang, Yuyan; Zhuo, Minglei; Li, Jianjie; Zhao, Xinghui; Yang, Xue; Zhong, Jia; Chen, Hanxiao; Dong, Zhi; Shi, Yuequan; Du, Feng; Wang, Jingjing; Chi, Yujia; Zhai, Xiaoyu; Wang, Ziping

doi:10.1111/1759-7714.12959

Cited by 17 publications

(16 citation statements)

References 21 publications

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“…Similar to a previous study [20], our subgroup analysis showed that OS is not signi cantly different between left and right PN (P=0.443). Age ≥61 (P≤0.002), higher tumor grade (P<0.001), and higher Nstage (P<0.05) were signi cant independent negative prognostic factors.…”

Section: Discussionsupporting

confidence: 90%

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

Wang

Liu

et al. 2020

Preprint

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Background: Prognostic factors in pneumonectomy (PN) are not yet fully defined. This study is to analyze and evaluate long-term survival after PN for non-small cell lung cancer (NSCLC). Methods: We obtained data from the Surveillance, Epidemiology, and End Results (SEER) database for patients who underwent PN between 2004 and 2015. In order to reduce bias and imbalance, propensity score matching (PSM) analysis was performed. We used Kaplan-Meier curves to estimate overall survival (OS), performed univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for OS, and applied the Cox proportional hazards model to create a forest plot. Results: A total of 1557 PN patients from the SEER database were included. The patients were grouped according to the side of PN. Before matching, OS was worse after right PN (hazard ratio [HR]: 1.303; 95% confidence interval [CI] 1.133-1.498; P<0.001), but survival difference between groups was not significant after matching (HR: 1.061; 95% CI 0.912-1.235; P=0.443). Regression analysis revealed that age, grade, N-stage, radiotherapy, and chemotherapy were independent predictors of OS (P<0.05). Chemotherapy was associated with improved OS (HR: 0.709; 95% CI 0.609-0.825; P<0.001), but radiotherapy was associated with increased risk of death in OS (HR: 1.268; 95% CI 1.061-1.561; P=0.009). On the forest plot, patients with primary overlapping lesions had better OS (HR: 0.684; 95% CI 0.497-0.941; P=0.020) in left, vs right, PN; patients diagnosis during 2004 to 2007 had lower OS (HR: 0.576; 95% CI 0.346-0.960; P=0.034) for left PN vs right PN.Conclusions: Laterality was not a significant prognostic factor for long-term survival after PN for NSCLC. Chemotherapy was a significant independent predictor of improved OS, while radiotherapy appeared to be a negative prognostic factor with increased risk of death in OS.

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Section: Discussionsupporting

confidence: 90%

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

Wang

Liu

et al. 2020

Preprint

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“…Hence, these tumors might not comprise separate entities and should be handled with the same oncological principles. These outcomes are supported by the results of a large Surveillance Epidemiology and End Results (SEER) analysis where the prognosis between right-and left-sided NSCLC in stage I-IIIA was similar, irrespective of whether patients had surgery performed or not (45). Furthermore, Puri et al (46) and Whitson et al (47) also concluded that the side-and regionspecific primary tumor localization does not influence survival in early-stage patients.…”

Section: Discussionmentioning

confidence: 83%

Bone-Specific Metastasis Pattern of Advanced-Stage Lung Adenocarcinoma According to the Localization of the Primary Tumor

Radeczky¹,

Moldvay²,

Fillinger³

et al. 2021

Pathol. Oncol. Res.

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Background: Patients with advanced-stage lung adenocarcinoma (LADC) often develop distant metastases in the skeletal system. Yet, the bone-specific metastasis pattern is still controversial. We, therefore, aimed to examine how the primary tumor location affects bone specificity and survival in LADC patients diagnosed with skeletal metastases.Methods: In total, 209 bone-metastatic Caucasian LADC patients from two thoracic centers were included in this study. Focusing on the specific location of primary tumors and bone metastatic sites, clinicopathological variables were included in a common database and analyzed retrospectively. Skeletal metastases were diagnosed according to the contemporary diagnostic guidelines and confirmed by bone scintigraphy. Besides region- and side-specific localization, primary tumors were also classified as central or peripheral tumors based on their bronchoscopic visibility.Results: The most common sites for metastasis were the spine (n = 103) and the ribs (n = 60), followed by the pelvis (n = 36) and the femur (n = 22). Importantly, femoral (p = 0.022) and rib (p = 0.012) metastases were more frequently associated with peripheral tumors, whereas centrally located LADCs were associated with humeral metastases (p = 0.018). Moreover, we deduced that left-sided tumors give rise to skull metastases more often than right-sided primary tumors (p = 0.018). Of note, however, the localization of the primary tumor did not significantly influence the type of affected bones. Multivariate Cox regression analysis adjusted for clinical parameters demonstrated that central localization of the primary tumor was an independent negative prognostic factor for overall survival (OS). Additionally, as expected, both chemotherapy and bisphosphonate therapy conferred a significant benefit for OS.Conclusion: The present study demonstrates unique bone-specific metastasis patterns concerning primary tumor location. Peripherally located LADCs are associated with rib and femoral metastases and improved survival outcomes. Our findings might contribute to the development of individualized follow‐up strategies in bone-metastatic LADC patients and warrant further clinical investigations on a larger sample size.

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“…Most recently a very large study including more than 90000 NSCLC patients was published [6]. The studied included patients in stages I-IIIa, whereas some underwent surgery, and some did not.…”

Section: Methodsmentioning

confidence: 99%

“…The theory proposed is that there is a difference in dose response between the right and left lung. Another study including data from 90407 NSCLC patients found that tumor laterality had no impact on overall survival [6].…”

Section: Introductionmentioning

confidence: 99%

The effect of tumor laterality on survival for non-small cell lung cancer patients treated with radiotherapy

et al. 2019

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Background: The treatment of choice for patients with locally advanced non-small cell lung cancer (LA-NSCLC) in good performance status is definitive radiotherapy (RT), the five year survival being approximately 25-30%. Advances in the diagnostic procedures and treatment modalities in NSCLC have increased the overall survival, making identifying factors with impact on survival increasingly relevant. Recent research indicates that tumor laterality has impact on the survival of patients with 2 LA-NSCLC treated with definitive RT. The aim of this study was to investigate whether tumor laterality impacted overall survival. Materials and methods: All patients with stage IIa-IIIb NSCLC planned for curative intended RT from 2008-2013 at Odense University Hospital were analyzed to compare overall survival of patients with right sided vs. left sided tumors. Logrank test was performed to test for differences in survival rates, and Cox regression analyses to test for possible confounders. No patients were lost to follow-up. Results: In total 164 patients had tumor in the right lung, and 118 had tumor in the left lung. All patients had at least 4.5 years' follow up. Median overall survival was 19 months (right) and 22.5 months (left) p=0.729. Three year overall survival was 31% (right) and 35% (left). In Cox regression analyses age, performances status, and total mean lung dose were statistically significant with a hazard ratio (HR)=1.03

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Survival comparison of right and left side non‐small cell lung cancer in stage I–IIIA patients: A Surveillance Epidemiology and End Results (SEER) analysis

Cited by 17 publications

References 21 publications

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

Bone-Specific Metastasis Pattern of Advanced-Stage Lung Adenocarcinoma According to the Localization of the Primary Tumor

The effect of tumor laterality on survival for non-small cell lung cancer patients treated with radiotherapy

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