Prognosis of Resected Non-small Cell Lung Cancer with Ipsilateral Pulmonary Metastasis

Ahmet Ucvet; Serkan Yazgan; Soner Gursoy; Ozgur Samancilar

doi:10.1055/s-0038-1667169

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2020; 68(02): 176-182
DOI: 10.1055/s-0038-1667169

Original Thoracic

Georg Thieme Verlag KG Stuttgart · New York

Prognosis of Resected Non-small Cell Lung Cancer with Ipsilateral Pulmonary Metastasis

Ahmet Ucvet

¹Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Medical Practice and Research Center, İzmir, Turkey

,

Serkan Yazgan

¹Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Medical Practice and Research Center, İzmir, Turkey

,

Soner Gursoy

¹Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Medical Practice and Research Center, İzmir, Turkey

,

Ozgur Samancilar

¹Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Medical Practice and Research Center, İzmir, Turkey

› Author Affiliations

Abstract

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Abstract

Background Ipsilateral pulmonary metastasis (PM) in the same lobe (T3_Satell) or different lobe (T4_{Ipsi Nod}) constitutes a small proportion of patients with non-small cell lung cancer (NSCLC). In our study, we aimed to determine prognostic factors and to evaluate long-term survival outcomes in the patients who underwent complete resection due to NSCLC.

Methods Data of 1,502 surgically treated patients with NSCLC from January 2007 to December 2016 were retrospectively reviewed. Fifty (3.3%) patients diagnosed with PM were the basis of the study. Demographic and histopathological characteristics, surgical procedures, and prognostic factors for survival were analyzed, categorizing patients according to the presence of PM in the same lobe or different lobe.

Results Among the 50 patients, 23 (46%) had PM in the same lobe as the primary tumor and 27 (54%) had PM in different ipsilateral lobes. The mean size of nodules was 11.5 mm. While T3_Satell was detected mostly in squamous cell carcinoma (SCC) (65.2%), T4_{Ipsi Nod} was more common in adenocarcinoma (AC) (70.4%), and the difference was statistically significant (p = 0.022). Survival was significantly better in the SCC-T3_Satell group than the AC-T3_Satell group (64 and 58.3%, respectively; p = 0.043). Although the overall 5-year survival was better in the T3_Satell group, the difference between survival outcomes of both groups was not statistically significant (61.2 and 37.2%, respectively; p = 0.27). In the T3_Satell group, nodule size was found to be a negative prognostic factor in survival (p = 0.042), whereas the number of nodules was found to be a negative prognostic factor in the T4_{Ipsi Nod} group (p = 0.046). In multivariate analysis, advanced age was a poor prognostic factor for PM (p = 0.03).

Conclusion There was no significant difference in survival between T3_Satell and T4_{Ipsi Nod} patients. Among surgically treated patients due to NSCLC, poor prognostic factors were advanced age for the patients with PM, nodule size and AC for T3_Satell patients, and the number of nodules for T4_{Ipsi Nod} patients.

Keywords

non-small cell lung cancer - intrapulmonary metastasis - satellite nodules - surgery - prognosis - tumor staging

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References

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