Does bronchial location of lung cancer influence overall survival?

Abstract

Background: To date, only little attention has been given to the possible influence of initial bronchial location of lung cancer (BLoLC) on survival. With the development of lung cancer screening by CT Scan, this may have some interest in clinical practice.

Methods: A total of 1370 newly diagnosed and histopathologically confirmed lung cancer cases were consecutively included in the study at the Nancy University Hospital between December 2002 and March 2013. BLoLC was classified as 'central' when the lesions were visible on bronchoscopic examination. Otherwise, they were considered as 'peripheral'. Data were collected using a standardized questionnaire and patient's medical records. The relationships between survival and BLoLC, besides other prognostic factors, including sex, age, TNM stage, and performance status (PS) were analyzed by multivariate models using the Cox proportional hazards model.

Results: A total of 1370 consecutive patients newly diagnosed for lung cancer were included in the current study, and 743 (54·2%) patients had centrally located lung carcinoma. In univariate analysis, peripheral BLoLC is significantly associated with a better survival at 5-years (19.3% vs 9.9%, p<0.001). In Cox models, peripheral BLoLC has still a better prognosis when adjusted for age, gender, performance status and tumor histology type. However, this effect appeared to be fully explained by TNM staging and surgery in NSCLC, but not in SCLC.

Conclusion: A peripheral BLoLC seems to be an independent factor of overall survival in SCLC, but not in NSCLC.