Surgical Outcomes of Synchronous Multiple Primary Non-Small Cell Lung Cancers

Abstract

The prognostic indicators for synchronous multiple primary non-small cell lung cancer (NSCLC) vary across reports. In present study, the prognostic factors for the patients with synchronous multiple primary NSCLC were analyzed in a large cohort. A total of 285 patients with synchronous multiple primary NSCLC who underwent radical surgical resection and with complete follow-up information were included in this study. The Kaplan-Meier method were used for survival analysis, Cox proportional hazards regression models were used for risk factors evaluation. Among them, 94 (33.0%) patients had bilateral tumors and 51 (17.9%) had multiple (≥3) tumors. The 5-year disease-free survival (DFS) and overall survival (OS) rate was 58.7% and 77.6%, respectively. Univariate analysis identified parameters conferring shorter OS including male gender, symptomatic disease, negative family history, large maximal tumor size, not all adenocarcinomas, advanced highest T stage, and lymph node involvement. Multivariate analysis showed that male gender (p = 0.020), symptomatic disease (p = 0.017), and lymph node involvement (p < 0.001) were independent adverse prognosticators. For patients with multiple adenocarcinomas, the 5-year DFS and OS rate was 59.6% and 82.4%, respectively. The subtypes other than lepidic predominant (p < 0.001) and lymph node involvement (p = 0.002) were the independent unfavorable prognosticators. In conclusion, we identified independent prognosticators which will provide the valuable clues for postoperative management of patients with synchronous multiple primary NSCLC.

What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

“…These were basically consistent with other researches [2][3][4][5][6][7]. The research of Shintani, T. et al [13] found that in SMPLC patients only treated with stereotactic body radiotherapy (SBRT), the 3-year OS rate and DFS rate were 69.1% and 43.2%, far lower than the surgical-based comprehensive treatment.…”

“…The research of Shintani, T. et al [13] found that in SMPLC patients only treated with stereotactic body radiotherapy (SBRT), the 3-year OS rate and DFS rate were 69.1% and 43.2%, far lower than the surgical-based comprehensive treatment. Other studies also supported this conclusion [14][15].Comprehensive studies had shown that the prognosis of patients with SMPLC was better than that of patients with lung cancer recurrence or metastasis [2][3][4][5][6][7].…”

“…This study showed that postoperative chemotherapy reduced DFS and OS rates, which may be related to the toxic and side effects of chemotherapy drugs themselves. Some literatures have shown that postoperative chemotherapy can bring survival bene ts [6,[16][17]. According to their research subjects, postoperative chemotherapy may bene t patients with late stage and positive lymph node metastasis.…”

A Population-Based Study of Outcomes in Surgically Resected T3N0 Non–Small Cell Lung Cancer in The Netherlands, Defined Using TNM-7 and TNM-8; Justification of Changes and an Argument to Incorporate Histology in the Staging Algorithm

“…Multiple stage I tumors within the same lobe are thought to have a good prognosis, with a reported 5-year OS of 82.4% for patients with multiple synchronous adenocarcinomas. 15 On the basis of the available database information, we are unable to distinguish between synchronous primaries and isolated lung metastases in our study group.…”

An Unusual Occurrence of Multiple Metachronous and Synchronous Primary Cancers in a Female Patient

“…It also requires informed participation by the patient in order to adapt to unforeseen developments. Other documented cases of localized multiple primary tumors have been managed with surgery or radiation therapy covering each malignancy [19,20]. As noted in this case report, this patient's multiple primary tumors have been managed similarly thus far.…”