Increased mortality in lung cancer patients with same-lobe, multi-lobe, or mixed nodules: a retrospective study of 166,097 participants from the SEER database.

Background: Lung cancer is a leading cause of cancer-related deaths globally, with a particularly high burden in China and a poor prognosis mainly due to late-stage diagnosis and limited effective treatments. Large-sample survival analyses are lacking for patients with lung cancer who nodules of present with same-lobe, multi-lobe, or mixed nodules, as well as those with multiple separate nodules. This study aimed to assess the survival rates of patients with lung cancer by focusing on overall survival and disease-specific survival. Methods: A large dataset of 166,097 patients with lung cancer was obtained from the Surveillance, Epidemiology, and End Results database. Survival analyses, including univariate, multivariate, and stratified analyses, and survival curves, were conducted using Empower Stats, SPSS 24, and GraphPad. Eight covariates, including age, sex, and race, were adjusted. Results: Compared to patients with a single-tumor, those with same-lobe nodules, multi-lobe nodules, or mixed-distribution nodules had a significantly increased mortality risk. Furthermore, stratified analysis indicated that, compared to patients with a single-tumor, the increase in mortality risk was substantially greater among patients who underwent surgical treatment than among those who did not receive surgery. Conclusions: Patients with lung cancer who have satellite nodules located in the same-lobe or in different lobes on the same side as the primary tumor have a significantly higher mortality risk than those with single tumors. Surgical intervention in these patients further increases this risk.