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Main bronchus location is a predictor for metastasis and prognosis in lung adenocarcinoma: A large cohort analysis.

ABSTRACT: OBJECTIVES:In the literature, inconsistent associations between the primary locations of lung adenocarcinomas (ADCs) with patient prognosis have been reported, due to varying definitions for central and peripheral locations. In this study, we investigated the clinical characteristics and prognoses of ADCs located in the main bronchus. METHODS:A total of 397,189 lung ADCs registered from 2004 to 2013 in the National Cancer Database (NCDB) were extracted and divided into main bronchus-located ADCs (2.5%, N?=?10,111) and non-main bronchus ADCs (97.5%, N?=?387,078). The ADCs located in the main bronchus and those not in the main bronchus were compared in terms of patient prognosis, lymph node involvement, distant metastases and other clinical features, including rate of curative-intent resection, histologic grade, and stage. RESULTS:ADCs located in the main bronchus had significantly worse patient survival than those in the non-main bronchus, both for all patients (HR?=?1.82, 95% CI 1.78-1.86) and for those undergoing curative-intent resection (HR?=?2.49, 95% CI 2.23-2.78). Furthermore, ADCs located in the main bronchus had a significantly higher rate of lymph node involvement and distant metastasis than those not in the main bronchus, when stratified by tumor size (trend test, p?

SUBMITTER: Yang L

PROVIDER: S-EPMC7678407 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Main bronchus location is a predictor for metastasis and prognosis in lung adenocarcinoma: A large cohort analysis.

Yang Lin L Wang Shidan S Gerber David E DE Zhou Yunyun Y Xu Feng F Liu Jiewei J Liang Hao H Xiao Guanghua G Zhou Qinghua Q Gazdar Adi A Xie Yang Y

Lung cancer (Amsterdam, Netherlands) 20180319

<h4>Objectives</h4>In the literature, inconsistent associations between the primary locations of lung adenocarcinomas (ADCs) with patient prognosis have been reported, due to varying definitions for central and peripheral locations. In this study, we investigated the clinical characteristics and prognoses of ADCs located in the main bronchus.<h4>Methods</h4>A total of 397,189 lung ADCs registered from 2004 to 2013 in the National Cancer Database (NCDB) were extracted and divided into main bronch ...[more]

PMID: 29748011

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Project description:AimsAlthough brain metastasis from gastric adenocarcinoma (GaC) is rare, it may significantly affect survival and quality of life. The aim of this large, comprehensive, population-based cohort investigation was to investigate factors that were associated with brain metastasis from GaC and to explore the prognostic factors and time-dependent cumulative mortalities among cases with GaC and brain involvement.MethodsPopulation-based information on cases with GaC diagnosed from 2010 to 2016 was obtained from a large-scale database. Factors that were associated with brain metastasis were investigated utilizing multivariable logistic regression. Time-dependent tumor-specific mortalities of cases with GaC and brain involvement were then computed utilizing the cumulative incidence functions (CIFs), and mortalities were compared between subgroups utilizing Gray's test. Factors that were associated with death were further evaluated utilizing multivariable Fine-Gray subdistribution hazard regression.ResultsTogether, 28,736 eligible cases were included, which comprised 231 (1%) cases with brain metastasis and 10,801 (38%) with metastasis to other sites, encompassing a follow-up of 39,168 person-years. Brain metastasis occurred more often among younger patients (within overall cancers), in cases with stomach cardia tumors, within cases with signet-ring cell carcinoma (within overall cancers), and within cases with positive lymph nodes (within overall tumors); it was less often detected among black people. Brain involvement was associated with more lung and bone metastases. The median survival time of cases having brain metastasis was only 3 months; the 6- and 12-month tumor-specific cumulative mortalities were 57% and 71%, respectively. Among cases with GaC and brain metastasis, those with gastric cardia cancers (when receiving radiotherapy), those undergoing resection, and those receiving chemotherapy had lower mortality risks, while younger patients (when receiving chemotherapy or radiotherapy) and people with positive lymph nodes (when receiving radiotherapy) had higher death hazards.ConclusionAmong patients with GaC, brain metastasis was correlated with several clinical and pathological variables, including ethnicity, age, cancer histology, location, lymph node involvement, and metastases to other sites. Cases having brain metastasis had poor survival that was correlated with age, cancer location, lymph node metastasis, and management. These findings offer vital clues for individualized patient care and future mechanistic explorations.

Dataset Information

Main bronchus location is a predictor for metastasis and prognosis in lung adenocarcinoma: A large cohort analysis.

Publications

Main bronchus location is a predictor for metastasis and prognosis in lung adenocarcinoma: A large cohort analysis.

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