Stage I synchronous multiple primary non-small cell lung cancer: CT findings and the effect of TNM staging with the 7th and 8th editions on prognosis

Li, Jingxu; Yang, Xia; Xia, Tingting; Guan, Yubao; Zhong, Nanshan

doi:10.21037/jtd.2017.12.101

Cited by 17 publications

(19 citation statements)

References 19 publications

(31 reference statements)

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“…Sumiyoshi et al ( 39 ) indicated that nerve invasion and clinical recurrence could serve as independent predictors for patients with lung adenocarcinoma, and Matsumura et al ( 12 ) suggested that vascular invasion could also function as an independent predictor ( 40 , 41 ). In the present study, multivariate analysis demonstrated that nerve invasion, vascular invasion and clinical recurrence were independent predictors for patients with lung adenocarcinoma ( Fig.…”

Section: Discussionmentioning

confidence: 99%

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Analyzing EGFR mutations and their association with clinicopathological characteristics and prognosis of patients with lung adenocarcinoma

et al. 2018

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Epidermal growth factor receptor (EGFR) is an important gene in the development of lung adenocarcinoma. However, there is controversy regarding the association between EGFR mutations and survival time of patients with lung adenocarcinoma. In the present study, tissue specimens and clinical data were collected from 219 patients with lung adenocarcinoma who had not undergone prior radiotherapy or chemotherapy. EGFR mutations were detected using a fluorescence polymerase chain reaction method, and the association between EGFR mutations and clinicopathological characteristics was analyzed. Overall survival (OS) curves were constructed using the Kaplan-Meier method and the influence of clinicopathological characteristics on OS was analyzed using the Cox regression model. The EGFR mutation rate was 50.7%, and the most common mutations were the L858R substitution mutation in exon 21 (L858R; 54.9%) and the deletion mutation in exon 19 (19-Del; 36%). The presence of EGFR mutations varied significantly with sex, smoking history, T stage, vascular invasion and adenocarcinoma subtypes (P<0.05). The survival time was significantly longer for female, young (<60 years-old), non-smokers or patients exhibiting EGFR mutations (G719X, 19-Del, L858R and L861Q). The survival time was also significantly longer for patients with a 19-Del mutation, early stage tumors, tyrosine kinase inhibitors targeted therapy-treated patients, for those not exhibiting nerve or vascular invasion, and for those without disease recurrence (P<0.05). Multivariate analysis revealed that tumor pathological Tumor-Node-Metastasis (pTNM) stage, nerve invasion, vascular invasion, EGFR mutation and the 19-Del mutation were independent predictors (P<0.05). Therefore, tumor pTNM stage, nerve invasion, vascular invasion and EGFR mutation status, particularly that of 19-Del, were independent prognostic factors for patients with lung adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

“…1E-G ). Previous studies have suggested that high pTNM stage is associated with poor prognosis ( 41 – 43 ). In the present study, high pTNM stage was associated with a relatively short survival time, and pTNM stage was demonstrated to be a predictor of prognosis ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Analyzing EGFR mutations and their association with clinicopathological characteristics and prognosis of patients with lung adenocarcinoma

et al. 2018

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“…Detailed assessment of predicted postoperative lung function is a prerequisite. The additional effects of bilateral chest wall dysfunction should also be considered (6).…”

Section: Synchronous Multiple Primary Non-small Cell Lung Cancers (Smmentioning

confidence: 99%

Surgical management of lung cancer with multiple lesions: implication of the new recommendations of the 8th edition of the TNM classification for lung cancer

Waller¹

2018

J. Thorac. Dis.

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The 8 th tumour, node and metastasis (TNM) revision of the staging classification for lung cancer has attempted to clarify the different properties of four distinct clinical presentations: synchronous multiple primary lung cancers; primary tumour with intrapulmonary metastases; pneumonic-type adenocarcinoma and multiple ground glass/lepidic lesions. The respective biological profiles determine different surgical strategies for each category. Accurate preoperative histological confirmation is required to identify synchronous primary tumours which should then be managed as two separate episodes within the confines of patient characteristics. Equally important is the confirmation of intrapulmonary metastasis which indicates a more conservative resection of the smaller lesion. In contrast, pneumonic-type adenocarcinoma may require larger parenchymal resection to achieve anatomical clearance but also symptom relief. Multiple subsolid lesions require a carefully planned strategy of parenchymal sparing and possible observation of less malignant abnormalities. In all the above situations careful clinical, radiological and pathological assessment is imperative to avoid one embarking on inappropriate invasive management. Either when the widespread nature of the disease renders extensive surgery futile or the relative benign or pre-malignant nature of the multiple lesions imply that the risks of surgery outweigh the prognostic benefits.

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“…Multiple primary lung cancer (MPLC) is defined as two or more primary lung cancers occurring in the same patient and can be classified into synchronous or metachronous multiple primary lung cancer based on the time of occurrence [ 1 ]. Numerous patients with multiple lung tumors are encountered, due to the availability of high-resolution CT scan and the increasing incidence of adenocarcinoma histology among non-small cell lung cancers.…”

Section: Introductionmentioning

confidence: 99%

Different driver gene mutations in patients with synchronous multiple primary lung cancers: a case report

Yang

Xie

Jiang

et al. 2020

J Cardiothorac Surg

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Background Routine clinical and pathological examinations usually cannot fully conclusively determine the relationship between different lesions of lung cancer. Detailed genetic analysis of tumor samples may supply important additional information and identify second primary lung cancers. Case presentation In the present study, we report a case of synchronous multiple primary lung cancer (MPLC) composed of two distinct pathological subtypes with epidermal growth factor receptor (EGFR) gene mutations L858R of the acinar adenocarcinoma subtype and EML4–ALK rearrangement of the squamous cell carcinoma. Conclusion The present report highlights the clinical importance of molecular cancer biomarkers detection to guide management decisions in MPLC cases.

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Stage I synchronous multiple primary non-small cell lung cancer: CT findings and the effect of TNM staging with the 7th and 8th editions on prognosis

Cited by 17 publications

References 19 publications

Analyzing EGFR mutations and their association with clinicopathological characteristics and prognosis of patients with lung adenocarcinoma

Analyzing EGFR mutations and their association with clinicopathological characteristics and prognosis of patients with lung adenocarcinoma

Surgical management of lung cancer with multiple lesions: implication of the new recommendations of the 8th edition of the TNM classification for lung cancer

Different driver gene mutations in patients with synchronous multiple primary lung cancers: a case report

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