Survival in synchronous vs single lung cancer: Upstaging better relects prognosis

OBJECTIVE: To define prognostic parameters for patients with synchronous non-small cell lung cancer (NSCLC). DESIGN: Retrospective study of period from 1970 through 1997. PATIENTS: Patients with a single (n = 2,764) and synchronous NSCLC (n = 85) who underwent pulmonary resection. 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