Surgical treatment is an effective approach for patients with synchronous multiple primary lung cancers

Peng, Yue; Ren, Wangang; Wang, Hui; Li, Meng; Feng, Zhen; Peng, Zhongmin

doi:10.4103/jcrt.jcrt_140_17

Cited by 14 publications

(17 citation statements)

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“…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.…”

Section: Discussionsupporting

confidence: 88%

“…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].…”

Section: Discussionmentioning

confidence: 79%

“…In our study, only 2 patients underwent bilateral surgery at the same time, and more patients chose surgeries in different times. The study of Peng, Y. et al [4] showed that simultaneous operation of bilateral lesions was feasible. There was no signi cant statistical difference in postoperative hospital stay between synchronous surgery and non-synchronous surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the intratumoral heterogeneity cannot be avoided in PCR or DNA sequencing analysis, the diagnosis of SMPLC cannot completely rely on molecular genetic characteristics. However, some studies still show that there were different gene mutations in different lesions of the same patient, and molecular gene detection can be used for the diagnosis of SMPLC [4,[21][22].…”

Section: Discussionmentioning

confidence: 99%

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

Wang

Zhang

et al. 2020

Preprint

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Background: With the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment for SMPLC.Methods: A total of 90 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.Results: Among 90 patients, the 1- and 3-year disease free survival (DFS) rates were 97.0% and 76.7% while the 1- and 3-year overall survival (OS) rates were 98.81% and 82.35%. Vascular infiltration (HR=402.46, p=0.005) and postoperative chemotherapy (HR>1000, p<0.001) were independent risk factors for DFS, while only postoperative chemotherapy (HR=184.10, p=0.002) was an independent risk factor for OS.Conclusions: First, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, for early stage SMPLC patients, vascular infiltration and postoperative chemotherapy are harmful to the survival.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Wang

Zhang

et al. 2020

Preprint

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“…We observed that the material-suppressed iodine image, as a virtual non-enhanced CT, which has a perfect image match, can reduce the measurement error from the position change of SPNs in different phases. We also found that the area under the curve of the enhancement degree [21,22], iodine concentration and 40 keV and 50 keV monochromatic the arterial phase were similar, which may be due to the linear correlation between CT attenuation value and iodine concentration for both monochromatic and polychromatic images [23]; thus, we did not do a series of parallel tests.…”

Section: Discussionmentioning

confidence: 91%

Energy spectrum computed tomography improves the differentiation between benign and malignant solitary pulmonary nodules

Zhao

Chai

Zhang

et al. 2019

CIM

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Purpose: To evaluate the diagnostic efficiency of computed tomography (CT) values at the 40~140 keV monochromatic level for the differential diagnosis of solitary pulmonary nodules (SPNs). Methods: Energy spectrum CT data of 44 patients with SPNs were analyzed retrospectively; 24 patients with malignant SPNs served as the malignant group and 20 patients with benign SPNs served as the benign group. The basic material concentration and the enhancement degree differences in double-phase enhanced scans were compared between the two groups. The sensitivity and specificity were calculated to determine diagnosis, and were compared with the pathology results. Results: The CT values at the 40~90 keV monochromatic level and the iodine concentrations of malignant group were higher than those of benign group in the arterial phase (all P < 0.05). The enhancement degree of the malignant group was higher than that for the benign group in the arterial phase (36.36 ± 33.18 HU vs 16.93 ± 24.17 HU t = 2.243, P = 0.030); however, the enhancement degrees of the two groups were similar in the venous phase (21.99 ± 15.87 HU vs 17.62 ± 24.15 HU t = 0.694, P = 0.493). The area under the curve of the enhancement degree in the arterial phase was 0.792. Conclusions: Monochromatic imaging and base material concentration of energy spectrum CT can help differentiate between benign and malignant SPNs.

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Characteristics and prognosis of synchronous multiple primary lung cancer after surgical treatment: A systematic review and meta‐analysis of current evidence

et al. 2020

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Background This study aims to quantitatively summary the characteristics of synchronous multiple primary lung cancer (sMPLC), postoperative mortality, long‐term prognosis, and prognostic effects of potential clinical parameters in patients with sMPLC after surgery. Methods PubMed and Embase databases were systematically searched to identify studies that explored the prognosis of patients with sMPLC after surgery. Results Fifty‐two studies with 3486 participants were included, and clinical characteristics were quantitatively summarized. The pooled proportion of sMPLC in lung cancer was 2.0% (95%CI, 1.6%–2.5%) with an increasing trend over time, and postoperative mortality was 1.4% (95%CI, 0.5%–2.7%) with a decreasing trend over time. The 5‐year survival rate was 44.9% (95%CI, 37.4%–52.6%) and all long‐term survival rates showed increasing trends over time. Poor long‐term prognosis was observed in both limited resection (HR = 1.357, 95%CI, 1.047–1.759, p = 0.0210) and pneumonectomy (HR = 2.643, 95%CI, 1.539–4.541, p = 0.0004) by comparison of anatomical resection. Other clinical parameters of age, gender, smoking status, FEV1, and lymph node metastasis significantly impacted the long‐term prognosis (all p < 0.05). Conclusions The proportion of sMPLC in lung cancer and 5‐year survival rate are increasing, while postoperative mortality is decreasing trend over time. Lobectomy should be preferred, while pneumonectomy should be avoided for sMPLC. Age, gender, FEV1, smoking, tumor size, surgical methods, and lymph node status are prognostic factors for sMPLC. Considering the heterogeneity and publication bias, these findings should be treated with caution.

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Surgical treatment is an effective approach for patients with synchronous multiple primary lung cancers

Abstract: SMPLC could be considered to be a local disease rather than the systemic disease. Surgical treatment is an effective approach for patients with SMPLC. Mutational status of EGFR could be used as a diagnostic criterion, especially in patients with SMPLA.

Cited by 14 publications

References 0 publications

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

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

Energy spectrum computed tomography improves the differentiation between benign and malignant solitary pulmonary nodules

Characteristics and prognosis of synchronous multiple primary lung cancer after surgical treatment: A systematic review and meta‐analysis of current evidence

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