Impact of primary tumor location on survival outcomes and recurrence patterns in patients with stage III non-small cell lung cancer: A retrospective observational study

IF 3.5 Q3 Medicine

Cancer treatment and research communications Pub Date : 2026-01-01 Epub Date: 2026-10-06 DOI:10.1016/j.ctarc.2026.101472

Chikashi Iwasaki, Eisaku Miyauchi, Takaya Yamamoto, Hisashi Tanaka, Yasuhito Nunomura, Yoshiomi Hatayama, Ryo Morita, Shin Fukui, Tatsunori Ito, Yoko Tsukita, Risa Ebina-Shibuya, Hisatoshi Sugiura

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引用次数: 0

Abstract

Background

Prognostic impact of primary tumor location in stage III non-small cell lung cancer (NSCLC) remains unclear in the era of concurrent chemoradiotherapy (CCRT) followed by consolidation durvalumab. Whether a lower lobe origin continues to influence survival and recurrence patterns under standardized multimodality therapy has not been fully elucidated.

Methods

This multicenter retrospective study included 136 patients with stage IIIA-IIIC NSCLC treated with definitive CCRT and durvalumab in 2018–2024. Baseline characteristics, recurrence patterns, and survival outcomes were compared between the lower and non-lower lobe groups. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan–Meier analyses and Cox proportional hazards models.

Results

Patients in the lower lobe group were older and showed differences in concurrent chemotherapy regimens, whereas most other factors were balanced. Lower lobe origin was associated with shorter OS (p = 0.014) and PFS (p = 0.011). On multivariable analysis, lower lobe location remained independently associated with poorer OS (HR, 2.21; 95% CI, 1.29–3.79; p = 0.004) and PFS (HR, 2.03; 95% CI, 1.24–3.33; p = 0.005) after adjustment for clinically relevant covariates. Exploratory analyses suggested more frequent pleural dissemination and liver metastasis in lower-lobe tumors despite similar primary tumor progression.

Conclusions

Lower lobe origin was independently associated with poorer survival in patients with stage III NSCLC treated with CCRT followed by consolidation durvalumab. These findings suggest that primary tumor location may provide additional prognostic information, although its implications for treatment or surveillance strategies require further investigation.

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原发肿瘤位置对III期非小细胞肺癌患者生存结局和复发模式的影响：一项回顾性观察性研究

背景：在同步放化疗（CCRT）和durvalumab巩固治疗的时代，原发肿瘤位置对III期非小细胞肺癌（NSCLC）预后的影响尚不清楚。在标准化的多模式治疗下，下肺叶起源是否继续影响生存和复发模式还没有完全阐明。方法：这项多中心回顾性研究纳入了2018-2024年间136例接受终期CCRT和杜伐单抗治疗的IIIA-IIIC期NSCLC患者。比较下肺叶组和非下肺叶组的基线特征、复发模式和生存结果。采用Kaplan-Meier分析和Cox比例风险模型评估总生存期（OS）和无进展生存期（PFS）。结果：下肺叶组患者年龄较大，在同期化疗方案上存在差异，而其他因素基本平衡。下肺叶起源与较短的OS （p = 0.014）和PFS （p = 0.011）相关。在多变量分析中，在调整临床相关协变量后，下肺叶位置仍然与较差的OS （HR, 2.21; 95% CI, 1.29-3.79; p = 0.004）和PFS （HR, 2.03; 95% CI, 1.24-3.33; p = 0.005）独立相关。探索性分析表明，尽管原发肿瘤进展相似，但下叶肿瘤的胸膜播散和肝转移更频繁。结论：下肺叶起源与接受CCRT和durvalumab巩固治疗的III期NSCLC患者较差的生存率独立相关。这些发现表明，原发肿瘤的位置可能提供额外的预后信息，尽管其对治疗或监测策略的影响需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.