Outcomes of Stage III NSCLC with occult primary vs. known primary lesions

•Occult primary NSCLC is a rare entity in which nodes are involved but no lung tumor is identifiable.•This is the first study to compare their outcomes to typical Stage III NSCLC patients.•Occult primary status was associated with notably better survival and disease control.•This difference suggests...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2019-01, Vol.127, p.34-36
Main Authors: Romesser, Paul B., Bardash, Yonatan, Buonocore, Darren, Chaft, Jamie E., Huang, James, Jones, David R., Rimner, Andreas, Wu, Abraham J.
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - radiotherapy
Carcinoma, Non-Small-Cell Lung - secondary
Cohort Studies
Definitive radiotherapy
Female
Humans
Lung cancer
Lung Neoplasms - mortality
Lung Neoplasms - radiotherapy
Lung Neoplasms - secondary
Male
Neoplasm Metastasis
Neoplasm Recurrence, Local
Neoplasm Staging
Neoplasms, Unknown Primary - mortality
Neoplasms, Unknown Primary - radiotherapy
Non-small cell lung cancer
Occult primary
Positron Emission Tomography Computed Tomography
Retrospective Studies
Survival Analysis
Treatment Outcome
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Summary:•Occult primary NSCLC is a rare entity in which nodes are involved but no lung tumor is identifiable.•This is the first study to compare their outcomes to typical Stage III NSCLC patients.•Occult primary status was associated with notably better survival and disease control.•This difference suggests a distinct biology for NSCLC patients with this presentation. Occult primary non-small cell lung cancer (OP-NSCLC) involving mediastinal lymph nodes without an identifiable primary tumor is a rare presentation, with little known about how outcomes compare to typical Stage III NSCLC. We reviewed our experience treating OP-NSCLC with definitive radiotherapy and compared outcomes to a contemporary cohort of stage III NSCLC patients. We reviewed 605 patients with stage III NSCLC staged with PET-CT and treated with definitive radiotherapy between 1998 and 2013. Overall survival, intrathoracic control, and freedom from distant metastasis were computed using Kaplan-Meier method and logrank comparison. Cox hazard ratios were used to perform univariate and multivariate analyses. Twenty-one patients were identified with OP-NSCLC (3.5%). Patients with OP-NSCLC, as compared to known primary NSCLC, had significantly better 5-year rates of intrathoracic control (83.5% vs. 24.2%, P 
ISSN:0169-5002
1872-8332
DOI:10.1016/j.lungcan.2018.11.019