Surgical treatment for synchronous multiple primary lung cancer: Is it possible to achieve both curability and preservation of the pulmonary function?

Thoracic Cancer

Shogo Yobita¹  Eriko Suzuki¹  Hiroyuki Tsuchida¹  Kensuke Iguchi¹  Takuya Watanabe¹  Suiha Uchiyama¹  Minori Nakamura¹  Masayuki Tanahashi¹  Naoko Yoshii¹ 

[1] Division of Thoracic Surgery, Respiratory Disease Center Seirei Mikatahara General Hospital Shizuoka Japan;

关键词: limited resection;    non‐small cell lung cancer;    pulmonary function;    surgery;    synchronous multiple lung cancer;   

DOI  :  10.1111/1759-7714.14164

来源: DOAJ

【 摘 要 】

Abstract Background With the advent of high‐resolution chest imaging, the number of patients diagnosed with multiple primary lung cancers is increasing. For the treatment of multiple lung cancers, a surgical procedure that preserves pulmonary function while ensuring curability is required. Methods The study population included 85 patients with synchronous multiple primary lung cancer who received surgical resection between January 2010 and September 2020. Patients with synchronous lung cancer within the same lobe were excluded, and only patients with ≥2 involved lobes were included. The postoperative pulmonary function was examined at 3–6 months after the surgery. Results Sixty‐seven patients had cancers within the ipsilateral lobe, and 18 patients had cancers in bilateral lobes. Seventy‐six patients (89.4%) underwent combination surgery with limited resection (e.g., segmentectomy and wedge resection). The preoperative pulmonary functions (mean VC/%VC, mean FEV1/%FEV1, and mean %DLCO) were 3.06 L/100.2%, 2.23 L/96.1%, and 117.2%, respectively, and the postoperative pulmonary functions were 2.45 L/81.4%, 1.87 L/81.2%, and 102.6%. In each parameter, the predicted reductions of pulmonary function were almost the same as the predicted values. The 5‐year survival rate was 85.0%. The 5‐year survival rate according to the most advanced pathological stage was 94.9% for stage I disease, and 62.6% for stage ≥II, which was a significant difference (p < 0.001). Conclusions Surgical treatment including limited resection, especially segmentectomy and wedge resection, for synchronous multiple primary lung cancer can preserve pulmonary function while ensuring curability.

【 授权许可】

Unknown