Surgical Treatment of Metachronous Second Primary Lung Cancer

Yang, Jie; Liu, Ming; Fan, Jie; Song, Nan; He, Wenxin; Yang, Yuling; Xia, Yan; Jiang, Gening

doi:10.1016/j.athoracsur.2014.05.050

Cited by 42 publications

(60 citation statements)

References 26 publications

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“…Generally, the extent of resection was based on the balance of risk and benefit of surgery, mainly considering characteristics of the tumor and performance status of patients, which might be different depending on individual surgeons. Regarding the extent of resection for the second tumors, the majority of the previous reports showed that sublobar resection is acceptable with comparable prognosis to anatomic lobar resections for SPLCs, appearing to support the use of limited resection in the treatment of metachronous lung cancer patients,1,4,10 which is inconsistent with some other studies 9,19. These outcomes are confusing because only the characteristics of the second tumor were analyzed and compared, even though the stage of the initial tumor might potentially affect the prognosis and not be completely reliable for drawing conclusions.…”

Section: Discussionmentioning

confidence: 97%

“…In this study, we highlighted SPLACs because adenocarcinoma accounts for the majority of reported MPLC cases, and previous outcomes are heterogeneous due to a variety of metachronous second malignancies are included 1,2,4,9–11…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have demonstrated significantly promising survival outcomes in patients with synchronous and metachronous MPLCs after surgical intervention 1–4…”

Section: Introductionmentioning

confidence: 99%

“…The most common histology of second MPLC is adenocarcinoma 1,2,4. Solitary lung adenocarcinoma has been widely investigated since the proposal by a joint working group of the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) in 2011 5.…”

Section: Introductionmentioning

confidence: 99%

“…However, the prognosis of lung adenocarcinomas as the second MPLC has not been studied in detail. In addition, the characteristics and surgical treatment of the initial lung cancer can also potentially affect the prognosis of MPLC patients, which was not considered in previous studies 1,3,4…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with metachronous second primary lung adenocarcinomas

Zhao¹,

Yang²,

Han³

et al. 2017

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BackgroundThe incidence of adenocarcinomas as multiple primary lung cancers (MPLCs) is increasing. How to determine the treatment strategies of MPLCs, especially second primary lung adenocarcinomas (SPLACs), and the prognostic factors associated with it are unclear.MethodsThe clinical records of patients undergoing surgery for second adenocarcinomas based on Martini–Melamed criteria between 2001 and 2014 were retrospectively reviewed. Survival rates were calculated by the Kaplan–Meier method and compared using the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards model.ResultsA total of 115 patients with SPLACs were identified based on Martini–Melamed criteria. With respect to the second resections, three subgroups with low- (adenocarcinoma in situ, n=6; minimally invasive adenocarcinoma, n=19), intermediate- (lepidic, n=9; acinar, n=40; papillary, n=23), and high-grades (solid, n=9; micropapillary, n=2; invasive mucinous, n=7) were assigned. The 5-year overall survival (OS) rates from the time of the first and the second resections were 86.5% and 69.5%, respectively. Cox multivariate analysis identified computed tomography (CT) morphology of SPLACs (ground glass opacity predominant versus solid predominant; hazard ratio [HR]=0.42; P=0.036), histologic classification (same/similar vs different; HR=0.06; P<0.001), pathologic stage of the primary (stage I vs II; HR=0.20; P=0.015) and second tumors (stage I vs IIIa; HR=0.21; P=0.002), and histologic grade of SPLACs (low- vs high-grade, HR=0.05, P=0.016; intermediate- vs high-grade, HR=0.37, P=0.027) as significantly favorable prognostic factors for OS.ConclusionIn addition to pathologic stage of the initial tumors and histologic classification, pathologic stage and CT morphology of SPLACs were identified as predictors of survival. The histologic grade of SPLACs based on the new adenocarcinoma classification could provide additional prognostic information.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…Many studies have demonstrated significantly promising survival outcomes in patients with synchronous and metachronous MPLCs after surgical intervention 1–4…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with metachronous second primary lung adenocarcinomas

Zhao¹,

Yang²,

Han³

et al. 2017

OTT

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Metachronous Lung Cancer: Clinical Characteristics and Effects of Surgical Treatment

Rzechonek

Błasiak

Muszczyńska-Bernhard

et al. 2017

Advances in Experimental Medicine and Biology

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The occurrence of a second lung tumor after surgical removal of lung cancer usually indicates a lung cancer metastasis, but sometimes a new lesion proves to be a new primary lung cancer, i.e., metachronous lung cancer. The goal of the present study was to conduct a clinical evaluation of patients with metachronous lung cancer and lung cancer metastasis, and to compare the early and distant outcomes of surgical treatment in both cancer types. There were 26 age-matched patients with lung cancer metastases and 23 patients with metachronous lung cancers, who underwent a second lung cancer resection. We evaluated the histological type of a resected cancer, the extent of thoracosurgery, the frequency of early postoperative complications, and the probability of 5-year survival after the second operation. The findings were that metachronous lung cancer was adenocarcinoma in 52% of patients, with a different histopathological pattern from that of the primary lung cancer in 74% of patients. In both cancer groups, mechanical resections were the most common surgery type (76% of all cases), with anatomical resections such as segmentectomy, lobectomy, or pneumectomy being much rarer conducted. The incidence of early postoperative complications in metachronous lung cancer and lung cancer metastasis (30% vs. 31%, respectively) and the probability of 5-year survival after resection of either cancer tumor (60.7% vs. 50.9%, respectively) were comparable. In conclusion, patients undergoing primary lung cancer surgery require a long-term follow-up due to the risk of metastatic or metachronous lung cancer. The likelihood of metachronous lung cancer and pulmonary lung cancer metastases, the incidence of postoperative complications, and the probability of 5-year survival after resection of metachronous lung cancer or lung cancer metastasis are similar.

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Impact of postoperative complications on outcomes of second surgery for second primary lung cancer

et al. 2020

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Surgical Treatment of Metachronous Second Primary Lung Cancer

Cited by 42 publications

References 26 publications

Clinical outcomes of patients with metachronous second primary lung adenocarcinomas

Clinical outcomes of patients with metachronous second primary lung adenocarcinomas

Metachronous Lung Cancer: Clinical Characteristics and Effects of Surgical Treatment

Impact of postoperative complications on outcomes of second surgery for second primary lung cancer

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