Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer

Varun Puri, Nitin Garg, Erin E. Engelhardt, Daniel Kreisel, Traves D. Crabtree, Bryan F. Meyers, G. Alexander Patterson, Alexander Sasha Krupnick

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Conventional thoracic surgical teaching suggests a worse outcome for lower lobe lung cancers. It is unclear whether this is due to stage migration or whether lobar location is an independent negative prognostic factor. Methods: We performed a retrospective review of our institutional database of patients undergoing resection for pathologic stage I or stage II lung cancer between Jan 2000 and December 2006. Survival analysis was used to compare outcomes in various groups using the log-rank test. Logistic regression analysis was used to compare the primary dependent variables; age, size, and location of tumor (both laterality and lobe), histology (adenocarcinoma, squamous, large cell, or neuroendocrine and others) and type of resection (wedge, lobectomy or segmentectomy, and pneumonectomy). Results: A total of 841 patients met the inclusion criteria. The mean age of patients was 64.9 years, mean tumor size 3.3 cm, and, 144 patients had N1 disease. The three-year and five-year survivals for stage I tumors were 346 of 478 (72.4%) and 277 of 497 (55.7%), respectively. There was no difference in survival based upon lobar location. The three-year and five-year survivals for stage II tumors were 81 of 175 (46.3%) and 39 of 150 (26%), respectively, and lobar location did not influence survival. Logistic regression analysis showed that for stage I tumors increasing age and having undergone a pneumonectomy were associated with worse survival, and for stage II tumors increasing age and adenocarcinoma histology were associated with worse survival. Conclusions: Tumor location within the lung does not predict survival in pathologic stage I/II non-small cell lung carcinoma. Increasing age, adenocarcinoma histology, and pneumonectomy as the resection may lead to worse long-term survival.

Original languageEnglish (US)
Pages (from-to)1053-1059
Number of pages7
JournalAnnals of Thoracic Surgery
Volume89
Issue number4
DOIs
StatePublished - Apr 1 2010

Fingerprint

Non-Small Cell Lung Carcinoma
Survival
Pneumonectomy
Neoplasms
Histology
Adenocarcinoma
Lung Neoplasms
Logistic Models
Regression Analysis
Segmental Mastectomy
Survival Analysis
Teaching
Thorax
Epithelial Cells
Databases
Lung

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Puri, V., Garg, N., Engelhardt, E. E., Kreisel, D., Crabtree, T. D., Meyers, B. F., ... Krupnick, A. S. (2010). Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer. Annals of Thoracic Surgery, 89(4), 1053-1059. https://doi.org/10.1016/j.athoracsur.2010.01.020

Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer. / Puri, Varun; Garg, Nitin; Engelhardt, Erin E.; Kreisel, Daniel; Crabtree, Traves D.; Meyers, Bryan F.; Patterson, G. Alexander; Krupnick, Alexander Sasha.

In: Annals of Thoracic Surgery, Vol. 89, No. 4, 01.04.2010, p. 1053-1059.

Research output: Contribution to journalArticle

Puri, V, Garg, N, Engelhardt, EE, Kreisel, D, Crabtree, TD, Meyers, BF, Patterson, GA & Krupnick, AS 2010, 'Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer', Annals of Thoracic Surgery, vol. 89, no. 4, pp. 1053-1059. https://doi.org/10.1016/j.athoracsur.2010.01.020
Puri, Varun ; Garg, Nitin ; Engelhardt, Erin E. ; Kreisel, Daniel ; Crabtree, Traves D. ; Meyers, Bryan F. ; Patterson, G. Alexander ; Krupnick, Alexander Sasha. / Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer. In: Annals of Thoracic Surgery. 2010 ; Vol. 89, No. 4. pp. 1053-1059.
@article{934f65d08a6d404c99ccb1522b4d4e7a,
title = "Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer",
abstract = "Background: Conventional thoracic surgical teaching suggests a worse outcome for lower lobe lung cancers. It is unclear whether this is due to stage migration or whether lobar location is an independent negative prognostic factor. Methods: We performed a retrospective review of our institutional database of patients undergoing resection for pathologic stage I or stage II lung cancer between Jan 2000 and December 2006. Survival analysis was used to compare outcomes in various groups using the log-rank test. Logistic regression analysis was used to compare the primary dependent variables; age, size, and location of tumor (both laterality and lobe), histology (adenocarcinoma, squamous, large cell, or neuroendocrine and others) and type of resection (wedge, lobectomy or segmentectomy, and pneumonectomy). Results: A total of 841 patients met the inclusion criteria. The mean age of patients was 64.9 years, mean tumor size 3.3 cm, and, 144 patients had N1 disease. The three-year and five-year survivals for stage I tumors were 346 of 478 (72.4{\%}) and 277 of 497 (55.7{\%}), respectively. There was no difference in survival based upon lobar location. The three-year and five-year survivals for stage II tumors were 81 of 175 (46.3{\%}) and 39 of 150 (26{\%}), respectively, and lobar location did not influence survival. Logistic regression analysis showed that for stage I tumors increasing age and having undergone a pneumonectomy were associated with worse survival, and for stage II tumors increasing age and adenocarcinoma histology were associated with worse survival. Conclusions: Tumor location within the lung does not predict survival in pathologic stage I/II non-small cell lung carcinoma. Increasing age, adenocarcinoma histology, and pneumonectomy as the resection may lead to worse long-term survival.",
author = "Varun Puri and Nitin Garg and Engelhardt, {Erin E.} and Daniel Kreisel and Crabtree, {Traves D.} and Meyers, {Bryan F.} and Patterson, {G. Alexander} and Krupnick, {Alexander Sasha}",
year = "2010",
month = "4",
day = "1",
doi = "10.1016/j.athoracsur.2010.01.020",
language = "English (US)",
volume = "89",
pages = "1053--1059",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer

AU - Puri, Varun

AU - Garg, Nitin

AU - Engelhardt, Erin E.

AU - Kreisel, Daniel

AU - Crabtree, Traves D.

AU - Meyers, Bryan F.

AU - Patterson, G. Alexander

AU - Krupnick, Alexander Sasha

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Background: Conventional thoracic surgical teaching suggests a worse outcome for lower lobe lung cancers. It is unclear whether this is due to stage migration or whether lobar location is an independent negative prognostic factor. Methods: We performed a retrospective review of our institutional database of patients undergoing resection for pathologic stage I or stage II lung cancer between Jan 2000 and December 2006. Survival analysis was used to compare outcomes in various groups using the log-rank test. Logistic regression analysis was used to compare the primary dependent variables; age, size, and location of tumor (both laterality and lobe), histology (adenocarcinoma, squamous, large cell, or neuroendocrine and others) and type of resection (wedge, lobectomy or segmentectomy, and pneumonectomy). Results: A total of 841 patients met the inclusion criteria. The mean age of patients was 64.9 years, mean tumor size 3.3 cm, and, 144 patients had N1 disease. The three-year and five-year survivals for stage I tumors were 346 of 478 (72.4%) and 277 of 497 (55.7%), respectively. There was no difference in survival based upon lobar location. The three-year and five-year survivals for stage II tumors were 81 of 175 (46.3%) and 39 of 150 (26%), respectively, and lobar location did not influence survival. Logistic regression analysis showed that for stage I tumors increasing age and having undergone a pneumonectomy were associated with worse survival, and for stage II tumors increasing age and adenocarcinoma histology were associated with worse survival. Conclusions: Tumor location within the lung does not predict survival in pathologic stage I/II non-small cell lung carcinoma. Increasing age, adenocarcinoma histology, and pneumonectomy as the resection may lead to worse long-term survival.

AB - Background: Conventional thoracic surgical teaching suggests a worse outcome for lower lobe lung cancers. It is unclear whether this is due to stage migration or whether lobar location is an independent negative prognostic factor. Methods: We performed a retrospective review of our institutional database of patients undergoing resection for pathologic stage I or stage II lung cancer between Jan 2000 and December 2006. Survival analysis was used to compare outcomes in various groups using the log-rank test. Logistic regression analysis was used to compare the primary dependent variables; age, size, and location of tumor (both laterality and lobe), histology (adenocarcinoma, squamous, large cell, or neuroendocrine and others) and type of resection (wedge, lobectomy or segmentectomy, and pneumonectomy). Results: A total of 841 patients met the inclusion criteria. The mean age of patients was 64.9 years, mean tumor size 3.3 cm, and, 144 patients had N1 disease. The three-year and five-year survivals for stage I tumors were 346 of 478 (72.4%) and 277 of 497 (55.7%), respectively. There was no difference in survival based upon lobar location. The three-year and five-year survivals for stage II tumors were 81 of 175 (46.3%) and 39 of 150 (26%), respectively, and lobar location did not influence survival. Logistic regression analysis showed that for stage I tumors increasing age and having undergone a pneumonectomy were associated with worse survival, and for stage II tumors increasing age and adenocarcinoma histology were associated with worse survival. Conclusions: Tumor location within the lung does not predict survival in pathologic stage I/II non-small cell lung carcinoma. Increasing age, adenocarcinoma histology, and pneumonectomy as the resection may lead to worse long-term survival.

UR - http://www.scopus.com/inward/record.url?scp=77949556532&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77949556532&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2010.01.020

DO - 10.1016/j.athoracsur.2010.01.020

M3 - Article

VL - 89

SP - 1053

EP - 1059

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -