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Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer

Background: Pleural metastasis in lung cancer found at diagnosis has a poor prognosis, with 5–11 months’ survival. We hypothesized that prognosis might be different for patients who have had curative-intent surgery and subsequent pleural recurrence and that survival might differ based on the locatio...

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Autores principales: Joubert, Kyla D., Okusanya, Olugbenga T., Mazur, Summer, Ryan, John P., Ekeke, Chigozirim N., Schuchert, Matthew J., Soloff, Adam C., Dhupar, Rajeev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584474/
https://www.ncbi.nlm.nih.gov/pubmed/34768370
http://dx.doi.org/10.3390/jcm10214846
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author Joubert, Kyla D.
Okusanya, Olugbenga T.
Mazur, Summer
Ryan, John P.
Ekeke, Chigozirim N.
Schuchert, Matthew J.
Soloff, Adam C.
Dhupar, Rajeev
author_facet Joubert, Kyla D.
Okusanya, Olugbenga T.
Mazur, Summer
Ryan, John P.
Ekeke, Chigozirim N.
Schuchert, Matthew J.
Soloff, Adam C.
Dhupar, Rajeev
author_sort Joubert, Kyla D.
collection PubMed
description Background: Pleural metastasis in lung cancer found at diagnosis has a poor prognosis, with 5–11 months’ survival. We hypothesized that prognosis might be different for patients who have had curative-intent surgery and subsequent pleural recurrence and that survival might differ based on the location of the first metastasis (distant versus pleural). This may clarify if pleural recurrence is a local event or due to systemic disease. Methods: A database of 5089 patients who underwent curative-intent surgery for lung cancer was queried, and 85 patients were found who had biopsy-proven pleural metastasis during surveillance. We examined survival based on pattern of metastasis (pleural first versus distant first/simultaneously). Results: Median survival was 34 months (range: 1–171) from the time of surgery and 13 months (range: 0–153) from the time of recurrence. The shortest median survival after recurrence was in patients with adenocarcinoma and pleural metastasis as the first site (6 months). For patients with pleural metastasis as the first site, those with adenocarcinoma had a significantly shorter post-recurrence survival when compared with squamous cell carcinoma (6 vs. 12 months; HR = 0.34) and a significantly shorter survival from the time of surgery when compared with distant metastases first/simultaneously (25 vs. 52 months; HR = 0.49). Conclusions: Patients who undergo curative-intent surgery for lung adenocarcinoma that have pleural recurrence as the first site have poor survival. This may indicate that pleural recurrence after lung surgery is not likely due to a localized event but rather indicates systemic disease; however, this would require further study.
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spelling pubmed-85844742021-11-12 Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer Joubert, Kyla D. Okusanya, Olugbenga T. Mazur, Summer Ryan, John P. Ekeke, Chigozirim N. Schuchert, Matthew J. Soloff, Adam C. Dhupar, Rajeev J Clin Med Article Background: Pleural metastasis in lung cancer found at diagnosis has a poor prognosis, with 5–11 months’ survival. We hypothesized that prognosis might be different for patients who have had curative-intent surgery and subsequent pleural recurrence and that survival might differ based on the location of the first metastasis (distant versus pleural). This may clarify if pleural recurrence is a local event or due to systemic disease. Methods: A database of 5089 patients who underwent curative-intent surgery for lung cancer was queried, and 85 patients were found who had biopsy-proven pleural metastasis during surveillance. We examined survival based on pattern of metastasis (pleural first versus distant first/simultaneously). Results: Median survival was 34 months (range: 1–171) from the time of surgery and 13 months (range: 0–153) from the time of recurrence. The shortest median survival after recurrence was in patients with adenocarcinoma and pleural metastasis as the first site (6 months). For patients with pleural metastasis as the first site, those with adenocarcinoma had a significantly shorter post-recurrence survival when compared with squamous cell carcinoma (6 vs. 12 months; HR = 0.34) and a significantly shorter survival from the time of surgery when compared with distant metastases first/simultaneously (25 vs. 52 months; HR = 0.49). Conclusions: Patients who undergo curative-intent surgery for lung adenocarcinoma that have pleural recurrence as the first site have poor survival. This may indicate that pleural recurrence after lung surgery is not likely due to a localized event but rather indicates systemic disease; however, this would require further study. MDPI 2021-10-22 /pmc/articles/PMC8584474/ /pubmed/34768370 http://dx.doi.org/10.3390/jcm10214846 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Joubert, Kyla D.
Okusanya, Olugbenga T.
Mazur, Summer
Ryan, John P.
Ekeke, Chigozirim N.
Schuchert, Matthew J.
Soloff, Adam C.
Dhupar, Rajeev
Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title_full Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title_fullStr Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title_full_unstemmed Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title_short Prognostic Difference of Pleural versus Distant Metastasis after Surgery for Lung Cancer
title_sort prognostic difference of pleural versus distant metastasis after surgery for lung cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584474/
https://www.ncbi.nlm.nih.gov/pubmed/34768370
http://dx.doi.org/10.3390/jcm10214846
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