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Chinese Journal of Thoracic Surgery(Electronic Edition) ›› 2025, Vol. 12 ›› Issue (02): 66-82. doi: 10.3877/cma.j.issn.2095-8773.2025.02.02

• Original Article • Previous Articles     Next Articles

Lung cancer laterality and prognosis of second lung cancer: a retrospective study of the SEER database

Liangbin Pan1,2, Nan Wang3, Haitao Ma2,3,(), Kai Xie3,()   

  1. 1. The Friendship Hospital of Ili Kazakh Autonomous Prefecture,Ili Prefecture Clinical Medical Research Institute,Yining 835000,China
    2. Department of Thoracic Surgery,The First Affiliated Hospital of Soochow University,Suzhou 215006,China
    3. Department of Thoracic and Cardiovascular Surgery,The Fourth Affiliated Hospital of Soochow University,Suzhou Dushu Lake Hospital,Medical Center of Soochow University,Suzhou 215000,China
  • Received:2025-01-27 Revised:2025-02-22 Accepted:2025-03-24 Online:2025-05-28 Published:2025-07-01
  • Contact: Haitao Ma, Kai Xie

Abstract:

Objective

To clarify the influence of the tumor-lateral nature (left/right) of second lung cancer(SLC) and its interaction with the extent of previous lung resection on the 5-year overall survival rate of patients.

Methods

Using data in the Surveillance, Epidemiology, and End Results(SEER)database from 1975 to 2018,the study enrolled the SLC patients with a history of surgery for lung malignancy.Kaplan-Meier survival analysis and Cox proportional risk model were used to investigate the effect of malignancy on 5-year overall survival in SLC patients.

Results

A total of 4 693 patients with SLC were screened,including 2 587 patients with right-sided SLC and 2 106 patients with left-sided SLC.The results of multivariate analysis showed that the SLC on the right side was an independent risk factor for poor prognosis of subjects[hazard ratio(HR):1.115,95% confidence interval(CI):1.036~1.200,P=0.004],and the position of the two lung cancers on the opposite laterality was also associated with the lower 5-year overall survival rate(HR:1.086,95% CI:1.006~1.172,P=0.034).

Conclusion

Tumor laterality is a key factor affecting the prognosis of SLC and may have a synergistic effect with the anatomical changes after previous lung resection.The survival disadvantage of patients with right SLC suggests that in the selection of surgical methods and postoperative follow-up,the risk assessment and individualized intervention of the right lung should be strengthened in order to improve the long-term prognosis.

Key words: Second lung cancer, Survival, SEER, Laterality

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