Haitang Yang1, Yifeng Sun1, Feng Yao1, Keke Yu2, Haiyong Gu1, Baohui Han3, Heng Zhao4. 1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. 2. Department of Pathology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. 3. Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. 4. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. Electronic address: h_zhao28@163.com.
Abstract
BACKGROUND: With the development of diagnostic techniques, the incidence of multiple pulmonary nodules has increased. The management of multiple primary lung cancer patients based on currently established criteria, however, remains controversial. METHODS: Patients who underwent curative operations for bilateral multiple primary lung cancer (BMPLC) based on the Martini-Melamed criterion between January 2001 and June 2014 were reviewed retrospectively. RESULTS: Bilateral lobectomies and lobectomies with contralateral sublobar resections were performed in 39 and 49 patients, respectively. Bilateral sublobar resections were performed in the remaining 13 cases. Overall survival at 3 and 5 years was 84.5% and 75.0%, respectively. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival (p = 0.752). Postoperative pathologic diagnosis classified by the most advanced TNM stage appeared to present a good correlation with prognosis in patients with BMPLC. Cox multivariate analysis identified the most advanced TNM stage (p = 0.018) and the number of lesions (p = 0.001) as significant predictors of overall survival. CONCLUSIONS: The prognosis of patients after bilateral surgical treatment with curative intent for BMPLC was shown to be promising. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival. Postoperative pathologic diagnosis classified by the most advanced TNM had a good correlation with prognosis in patients with BMPLC.
BACKGROUND: With the development of diagnostic techniques, the incidence of multiple pulmonary nodules has increased. The management of multiple primary lung cancerpatients based on currently established criteria, however, remains controversial. METHODS:Patients who underwent curative operations for bilateral multiple primary lung cancer (BMPLC) based on the Martini-Melamed criterion between January 2001 and June 2014 were reviewed retrospectively. RESULTS: Bilateral lobectomies and lobectomies with contralateral sublobar resections were performed in 39 and 49 patients, respectively. Bilateral sublobar resections were performed in the remaining 13 cases. Overall survival at 3 and 5 years was 84.5% and 75.0%, respectively. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival (p = 0.752). Postoperative pathologic diagnosis classified by the most advanced TNM stage appeared to present a good correlation with prognosis in patients with BMPLC. Cox multivariate analysis identified the most advanced TNM stage (p = 0.018) and the number of lesions (p = 0.001) as significant predictors of overall survival. CONCLUSIONS: The prognosis of patients after bilateral surgical treatment with curative intent for BMPLC was shown to be promising. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival. Postoperative pathologic diagnosis classified by the most advanced TNM had a good correlation with prognosis in patients with BMPLC.