Objective: To define prognostic parameters for patients
with synchronous non-small cell lung cancer (NSCLC).
Design: Retrospective study of period from 1970 through
Patients: Patients with a single (n = 2,764)
and synchronous NSCLC (n = 85) who underwent pulmonary
Methods: All tumors were classified
postsurgically, and the tumors of the patients with synchronous lung
cancer were staged separately. The most advanced tumor was used for
comparison. Actuarial survival time was estimated, and risk factors
influencing survival were evaluated. Patients who died within 30 days
of surgery were excluded.
Measurement and results:
Five-year survival for single NSCLC was 41% and for synchronous lung
cancer it was 19%. The relative risk of death for patients with
synchronous lung cancer was 1.75, compared to that for patients with
single lung cancer. The most advanced tumor in synchronous cancer was a
significant predictor of survival (p < 0.005). The survival of
patients with synchronous lung cancer in which the most advanced tumors
were stage I (n = 40) and stage II (n = 27) was not different from
that of patients with stage II (n = 834) and stage IIIA (n = 405)
single lung cancer, respectively.
poorer survival of patients with synchronous NSCLC is confirmed and
quantified. The stage of the most advanced tumor was the best predictor
of prognosis. The prognosis of patients with synchronous NSCLC
resembles the prognosis of patients with a single lung cancer of a
higher stage. Upstaging in synchronous lung cancer is recommended on
the basis of these observations.