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

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机构： [a]Department of Pathology, National Cancer Center, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, China [b]Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA [c]Division of Hematology Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA [d]Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA [e]Department of Data Science, University of Mississippi Medical Center, MS, 39216, USA [f]Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China [g]Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, 75390, USA [h]Department of Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA [i]Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, TX, 75390, USA

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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. 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. 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 < e-16). Multivariate analysis of overall survival showed that main bronchus location is a prognostic factor (HR = 1.15, 95% CI 1.08-1.23) independent of other clinical factors. Main bronchus location is an independent predictor for metastasis and worse outcomes irrespective of stage and treatment. Tumor primary location might be considered in prognostication and treatment planning. Copyright © 2018 Elsevier B.V. All rights reserved.

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出版当年[2018]版：

大类 | 2 区医学

小类 | 2 区呼吸系统 3 区肿瘤学

最新[2023]版：

大类 | 2 区医学

小类 | 3 区肿瘤学 3 区呼吸系统

第一作者：

第一作者机构： [a]Department of Pathology, National Cancer Center, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, China [b]Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA

通讯作者：

通讯机构： [b]Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA [d]Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA [g]Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, 75390, USA [*1]Quantitative Biomedical Research Center,University of Texas Southwestern Medical Center, Dallas, Texas, 75390, USA

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