Diagnosis and management of synchronous lung cancers

Ferguson, Mark K.; DeMeester, Tom R.; Deslauriers, Jean; Little, Alex G.; Piraux, Michel; Golomb, Harvey M.

doi:10.1016/s0022-5223(19)38787-2

Cited by 141 publications

(53 citation statements)

References 9 publications

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“…Recent developments in various imaging and therapeutic modalities have increased the ability to identify either synchronous or metachronous multiple primary lung cancers. The incidence of multiple primary lung cancers has been reported to range from 0.7% to 15% of patients with lung cancer 2‐6. Distinguishing multiple primary lung cancers from intrapulmonary metastasis is difficult in a substantial number of cases, thus hindering the administration of appropriate therapeutic strategies.…”

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confidence: 99%

Discrimination of multiple primary lung cancers from intrapulmonary metastasis based on the expression of four cancer‐related proteins

Ono

Sugio

Uramoto

et al. 2009

Cancer

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BACKGROUND: Because distinguishing between multiple primary lung cancers and intrapulmonary metastasis is often difficult when the tumor histology is same, the feasibility of analyzing differential protein expression profiles to distinguish multiple primary lung cancers from intrapulmonary metastasis was evaluated. METHODS: This study enrolled 50 patients, with multiple primary lung cancers demonstrating the same histology, who underwent surgery between April 1994 and March 2006 and 20 patients who were diagnosed to have intrapulmonary metastasis during the same period. Thirty patients with lymph‐node metastasis were selected for comparison purposes. The sum value of the differences in the expression ratio of 4 proteins (p53, p16, p27, and c‐erbB2) was evaluated in immunohistochemically stained specimens among multiple primary lung cancers and intrapulmonary metastasis. RESULTS: None of the 30 patients with lymph‐node metastasis showed a sum value of the differences between primary tumor and lymph‐node metastasis in the 4 protein expression ratios >90. Therefore, when the difference between 2 tumors exceeded 90, the 2 tumors were considered to be different from each other, ie, multiple primary lung cancers. Forty‐one of 50 (82%) patients who were clinically diagnosed to have multiple primary lung cancers showed a sum value of the differences in their protein expression ratios >90, 4 of 20 (20%) patients who were clinically diagnosed to have intrapulmonary metastasis showed a sum value >90. Among the patients who were clinically diagnosed to have multiple primary lung cancers and intrapulmonary metastasis, the 5‐year survival of 70 patients who had a sum value of the differences in their 4 protein expression ratios, either >90 (newly classified multiple primary lung cancers) and ≤90 (newly classified intrapulmonary metastasis), were 81.1% and 40.2%, respectively (P = .002). CONCLUSIONS: The profile of protein expression in cancer‐related genes is, thus, considered to be a useful tool for distinguishing multiple primary lung cancers from intrapulmonary metastasis and for determining the appropriate biological staging of lung cancer. Cancer 2009. © 2009 American Cancer Society.

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confidence: 99%

Discrimination of multiple primary lung cancers from intrapulmonary metastasis based on the expression of four cancer‐related proteins

Ono

Sugio

Uramoto

et al. 2009

Cancer

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“…Still controversial remains the optimal management of patients with synchronous lung tumors. The operative management of these patients requires careful analysis at each stage of evaluation and the extension of resected lung tissue depends on localization of each tumors [1,10]. The treatment for patients with large cell neuroendocrine carcinoma has been based on non-small cell carcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple synchronous primary lung cancers are unusual and the incidence is reported around 0.2−20% [1]. Recently its rise has been noted due to widespread use and improvements in computed tomography (CT), positron emission tomography (PET) and other diagnostic methods.…”

Section: Introductionmentioning

confidence: 99%

Synchronous Two Distinct Neuroendocrine Lung Cancer Lesions

Rydel

Czyżewski

Stęplewska

et al. 2015

Advances in Respiratory Medicine

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The synchronous primary lung tumors is a rare condition and presented patient is the first reported case of simultaneous two distinct neuroendocrine lung cancer lesions in the same lobe. We present the case of a 55-year-old woman with synchronous two distinct neuroendocrine lung cancer lesions in the right upper lobe. Initially she showed no signs or symptoms related to lung lesions and was admitted to Thoracic Surgery Ward for the investigation of two oval, solitary pulmonary nodules (11 and 19 mm in diameter) detected on a chest X-ray performed three months earlier. The radiological imaging showed a variability of growth of both lesions (smaller tumor has enlarged while the larger one remained unchanged). After the CT-guided lung biopsy, patient underwent right upper lobectomy. Histological examination revealed a small cell carcinoma in one of the tumors and a large cell neuroendocrine carcinoma in the other one. The patient was discharged in good condition and lung inflation in chest X-ray and qualified for adjuvant chemotherapy with a combination of cisplatin and etoposide and the prophylactic cranial irradiation. Very important issues, having impact on outcome of patients with multiple lung tumours is differentiation whether the lesions are metastases or synchronous primary lung tumors and the optimal management of these patients.

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“…Częstość występowania mnogich nowotworów płuc wzrasta wraz z okresem obserwacji, a ponieważ dane z publikowanych badań dotyczą różnych okresów obserwacji, odsetek występowania MPLC różni się znacząco -od 0,2% do 20% [23]. Dla potrzeb epidemiologicznych należy więc posługiwać się odsetkiem nowych przypadków na rok obserwacji.…”

Section: Dyskusjaunclassified

Synchroniczne mnogie pierwotne raki płuca u 65-letniego mężczyzny z wieloletnim wywiadem nikotynowym. Opis przypadku

Swietlik

Doboszyńska

Kupis

et al. 2014

Advances in Respiratory Medicine

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Here we present a 65-year old ex-smoker with history of recent surgery for vocal cord tumor (histology: moderate grade intraepithelial neoplasia), who reported to the pulmonary outpatient clinic for the nodular lesions in the left lung seen on chest X-ray. Subsequent chest CT scan revealed focal lesion of 18 mm in diameter with spicular margins located in the right upper lobe, another irregular cyst with septa, 62 × 58 mm in the right lower lobe, and calcified nodule in the left lung, no enlarged lymph nodes or pleural effusion was seen. He underwent upper right lobe resection and wedge resection of the lower right lobe. Histological examination revealed adenocarcinoma in the right upper lobe with lymph node metastasis (pT2aN2M0). Examination of the right lower lobe showed squamous cell carcinoma (pT2bN0M0). He was subsequently treated with adjuvant chemotherapy and radiotherapy. During 20 months of the follow-up, he remained in good health with no signs of the disease progression. Patients with synchronous multiple primary lung cancers have significantly less favorable outcome than those with single primary lung malignancies, although it can be considerably improved with radical surgical treatment. Basing on the above case report, we discussed diagnostic and therapeutical scheme in patients with the primary multiple lung cancers, and have analyzed epidemiological data and some aspects of MPM etiology.

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Diagnosis and management of synchronous lung cancers

Cited by 141 publications

References 9 publications

Discrimination of multiple primary lung cancers from intrapulmonary metastasis based on the expression of four cancer‐related proteins

Discrimination of multiple primary lung cancers from intrapulmonary metastasis based on the expression of four cancer‐related proteins

Synchronous Two Distinct Neuroendocrine Lung Cancer Lesions

Synchroniczne mnogie pierwotne raki płuca u 65-letniego mężczyzny z wieloletnim wywiadem nikotynowym. Opis przypadku

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