P190. Relationship between long-term clinical outcomes and optimal time interval in patients with bilateral synchronous multiple primary lung cancers: A multi-institutional cohort study
Cancer Hospital, Chinese Academy of Medical Sciences
Beijng, Beijing
China - Contact Me
Guo Wei is an Associate Chief Physician in the Department of Thoracic Surgery at the Cancer Hospital, Chinese Academy of Medical Sciences. He holds an MD-PhD from Peking Union Medical College and is recognized as a Beijing Science and Technology New Star and recipient of the Youth Talent Support Program. His research focuses on the surgical treatment and translational research of lung cancer.
Dr. Guo leads several key projects, including the National Natural Science Foundation Youth Program. He has published 33 papers in high-impact journals such as Journal of Thoracic Oncology and Nature Communications, with over 1,400 citations and an H-index of 21.
He has presented at major conferences, including the WCLC, ASCO, AACR, and ESMO. Dr. Guo was named one of the 35 Under 35 Outstanding Young Oncologists.
Description
To assess the optimal time interval between two subsequent surgeries that can bring survival benefits to patients with bilateral synchronous multiple primary lung cancer (sMPLC), and to evaluate the association between the time interval and prognosis.
Methods:
This multi-institutional cohort study included 901 patients with bilateral sMPLC who underwent two surgeries between January 2017 and December 2022 at six academic institutions in China. Patients were divided into three groups based on the time interval between their 1st and 2nd surgeries: Group-I (≤ 75 days), Group-II (75-180 days), and Group-III (> 180 days). The study evaluated overall survival (OS) and disease-free survival (DFS) using Kaplan-Meier analysis and multivariable Cox regression to explore the prognostic significance of the time intervals between surgeries.
Results:
The median age of the patients was 59 years (interquartile range: 53-65 years). Group-I included 239 patients (26.5%), Group-II had 344 patients (38.2%), and Group-III had 318 patients (35.3%). Two lesions were identified in 436 patients (48.4%), while 48 patients (5.3%) had more than five lesions. The median OS time from the second surgery for the entire cohort was 49.2 months. Patients in Group-II (75-180 days between surgeries) showed the most favorable clinical outcomes compared to Group-I and Group-III (log-rank: OS, P = 0.0031; DFS, P < 0.0001) (Figure 1A and 1B ). In multivariable Cox regression analyses, patients in Group-I (HR, 2.832; 95% CI, 1.025-7.82; P = 0.045) and Group-III (HR, 4.998; 95% CI, 1.862-13.417; P = 0.001) were significantly associated with worse prognosis compared to Group-II. Additionally, Group-III had a higher incidence of postoperative complications, while Group-I showed significantly reduced lung function.
Conclusions:
For patients with bilateral sMPLC, the time interval between the two surgeries is a crucial factor influencing prognosis. The optimal time interval appears to be between 75 and 180 days, which is associated with better survival outcomes and fewer complications compared to shorter or longer intervals.
Authors
Wei Guo (1), Jie He (2)
Institutions
(1) Cancer Hospital, Chinese Academy of Medical Sciences, Beijng, Beijing, (2) CICAMS, Beijing