Predictors of primary lung cancer in a solitary pulmonary lesion after a previous malignancy

Nakadate, Akie; Nakadate, Masashi; Sato, Yasunori; Nakagawa, Takayuki; Yoshida, Katsuya; Suzuki, Yoshio; Yoshida, Yukihiro

doi:10.1007/s11748-017-0825-6

Cited by 14 publications

(20 citation statements)

References 27 publications

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“…Size and SUV max of the PLs were investigated as predictive factors of NLC; some sources stated (<3 cm) smaller lesions 29 while several others expressed that larger lesions (>3 cm) were more frequent in their studied NLC groups. 17 Nakadate et al revealed that NLC patients had significantly larger PLs, which also have significantly higher SUV max uptakes than PM patients. 17 In our study, NLC patients with a prior extrapulmonary malignancy had significantly greater tumor size (>2 cm) and significantly higher SUV max values (>5 g/mL) (p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…17 Nakadate et al revealed that NLC patients had significantly larger PLs, which also have significantly higher SUV max uptakes than PM patients. 17 In our study, NLC patients with a prior extrapulmonary malignancy had significantly greater tumor size (>2 cm) and significantly higher SUV max values (>5 g/mL) (p < 0.05). Since the smaller malignant nodules mostly have a lower SUV max value than the larger malignant nodules, 35 it is possible that NLC patients have greater SUV max values.…”

Section: Discussionmentioning

confidence: 99%

“…16 Therefore, it is important to distinguish newly occurring PLs as NLC or PM because tumors with different natures correspond to different surgical and therapeutic strategies. 17 An intraoperative diagnosis on frozen section pathological examination may not be accurate and precise, as seen in various studies, and has a limitation as reported by Marchevsky et al 18 Moreover, the differentiation between PM and NLC of PLs by intraoperative frozen sections in patients with a history of previous malignancy remains a difficult clinical dilemma; this dilemma is especially challenging and cumbersome if previous malignancy and PL share the same histopathology subtype. 19 This is mostly observed in patients with previous head and neck cancers who developed squamous cell carcinoma of the lungs 20 and patients with previous colorectal carcinoma who developed adenocarcinoma of the lungs.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and surgical approaches for malignant pulmonary lesions after a previous extrapulmonary malignancy

Seyrek¹,

Cansever

Bedirhan

2021

ANZ Journal of Surgery

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Background: In our study, since the operative histopathological distinction of new malignant pulmonary lesions as either a primary lung cancer or a pulmonary metastasis is difficult, we aimed to identify the clinical variables which might allow distinction between a new lung cancer and a pulmonary metastasis, and the appropriate surgical management. Methods: We divided 55 cases into two groups: patients with new lung cancer (NLC, n = 32) and patients with pulmonary metastases (PM, n = 23). Based on the primary organ, the previous malignancy was classified into four categories: head and neck, colorectal, genitourinary, and breast cancer. The parameters included in the study were age, sex, smoking history, a family history of cancer, disease-free interval, primary organ, treatments for previous malignancies, size, and SUV max of the lung lesion on 18F-fluorodeoxyglucose positron emission tomography scan and high-resolution computed tomography findings of the lung lesion. Results: A predisposition for larger lesions was found in the NLC group. In addition, in the NLC group, disease-free interval was noted to be longer, patients were significantly older and SUV-max values of solitary pulmonary lesions were significantly higher than in the PM group. Pulmonary lesions in patients with prior head and neck cancers were more likely to develop NLC. No significant difference in statistical analysis was observed between the groups in terms of sex, smoking, a family history of cancer, a history of adjuvant therapy, radiological pulmonary lesions signs, and localization. Conclusion: PL monitoring on CT surveillance is essential, particularly in patients with previous head and neck cancers, who appear to have a higher risk for NLC. If pathological MLN accompanies PL in a patient with previous extrapulmonary malignancy, cervical mediastinoscopy may help acquire a possible PL diagnosis besides mediastinal staging. Intraoperative frozen section may have difficulty in distinguishing between PM and NLC when the lesion is of the same histological type as the previous malignancy. When precise distinction cannot be achieved by frozen section, we speculate that DFI, age, and radiological findings of the PL may help thoracic surgeons take initiative peroperatively while designating the subsequent surgical intervention. Lastly, pulmonary segmentectomy is also better be considered along with lobectomy in NLC cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and surgical approaches for malignant pulmonary lesions after a previous extrapulmonary malignancy

Seyrek¹,

Cansever

Bedirhan

2021

ANZ Journal of Surgery

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“…The combination of radiological findings, smoking history, and type of previous malignancy can reportedly improve the ability to predict primary lung cancer in the presence of a solitary pulmonary lesion that appears after treatment for a previous malignancy (17). The actual frequency of the diagnosis of SPN is also useful information.…”

Section: The Evaluation Of Pulmonary Nodules In Patients With a History Of Malignancymentioning

confidence: 99%

Preoperative evaluation and indications for pulmonary metastasectomy

Kanzaki¹,

Fukui²,

Kanou³

et al. 2021

J Thorac Dis

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Pulmonary metastasectomy (PM) is an established treatment that can provide improved longterm survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM.

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“…Our evaluation of the prognostic significance of GGOs was restricted to patients with a prior history of lung cancer. Although several studies have assessed the likelihood of identifying a malignant lesion during GGO resection among patients with prior malignant lesions [27][28][29], ours is the first study to describe the natural history of GGO in patients with a history of only lung cancer.…”

Section: Commentmentioning

confidence: 99%

Natural History of Ground-Glass Lesions Among Patients With Previous Lung Cancer

Shewale

Nelson

Rice

et al. 2018

The Annals of Thoracic Surgery

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Predictors of primary lung cancer in a solitary pulmonary lesion after a previous malignancy

Abstract: A combination of radiological findings, smoking history, and type of previous malignancy can improve the ability to predict primary lung cancer in the presence of a solitary pulmonary lesion that appears after previous treatment for a malignancy.

Cited by 14 publications

References 27 publications

Clinical and surgical approaches for malignant pulmonary lesions after a previous extrapulmonary malignancy

Clinical and surgical approaches for malignant pulmonary lesions after a previous extrapulmonary malignancy

Preoperative evaluation and indications for pulmonary metastasectomy

Natural History of Ground-Glass Lesions Among Patients With Previous Lung Cancer

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