HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Delphine Trousse Christophe Doddoli Roger Giudicelli Pierre Fuentes Pascal Thomas Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Trousse, D. Articles by Thomas, P. Search for Related Content PubMed PubMed Citation Articles by Trousse, D. Articles by Thomas, P.

J Thorac Cardiovasc Surg 2007;133:1193-1200
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Synchronous multiple primary lung cancer: An increasing clinical occurrence requiring multidisciplinary management

^a Department of Thoracic Surgery, Sainte Marguerite University Hospital, Marseille, France
^b Department of Thoracic Oncology, Sainte Marguerite University Hospital, Marseille, France
^d Department of Pathology, Sainte Marguerite University Hospital, Marseille, France
^c Department of Public Health and Biostatistics, Faculty of Medicine, Université de la Méditerranée (Aix-Marseille II) and Assistance Publique-Hôpitaux de Marseille, Marseille, France.

Received for publication September 29, 2006; revisions received December 16, 2006; accepted for publication January 5, 2007.

^_* Address for reprints: Pascal Thomas, MD, FECTS, Department of Thoracic Surgery, Ste Marguerite Hospital-CHU Sud, 270 Bd Ste Marguerite, 13274 Marseille Cedex 9, France. (Email: pathomas{at}ap-hm.fr).

Objective: No guidelines detailing recommendations for the selection and treatment of patients with synchronous multiple primary lung cancer have been published. We report on a single-institution experience with synchronous multiple primary lung cancer, with emphasis on long-term survival.

Methods: We performed a retrospective study of 125 consecutive patients with synchronous multiple primary lung cancer who underwent operation between 1985 and 2006. Various treatment strategies were applied, including perioperative therapy. Potential prognosticators were submitted to univariate and multivariate analyses.

Results: Tumors were bilateral (n = 34) or ipsilateral (n = 91). Optimal surgical treatment (complete anatomic resection with radical lymphadenectomy) was possible in 65.6% of the cases. pN0 disease was present in 32.3% of the patients; 30-day and 90-day mortality rates were 4.5% and 11%, respectively. Two- and 5-year overall survivals were 61.6% and 34%, respectively, with a median survival of 35 months. On univariate analysis, smoking status, high Charlson index, low forced expiratory volume in 1 second, occurrence of postoperative complications, and performance of a pneumonectomy affected the overall survival adversely. Conversely, bilateral disease, location in the same lobe, and pN0 disease were favorable prognosticators. On multivariate analysis, low forced expiratory volume in 1 second, nonoptimal surgical treatment, and performance of a pneumonectomy were independent predictors of poor long-term survival, whereas female sex, younger age, asymptomatic disease, pN0 status, and performance of an adjuvant treatment affected the survival favorably.

Conclusions: Provided there is an appropriate selection process, patients with synchronous multiple primary lung cancer are expected to benefit from surgery. Optimal surgery should be performed, but pneumonectomy should be avoided whenever possible. Adjuvant treatment is suggested to provide an added survival advantage.

This article has been cited by other articles:

				W. N. William Jr, H. Y. Lin, J. J. Lee, S. M. Lippman, J. A. Roth, and E. S. Kim Revisiting Stage IIIB and IV Non-small Cell Lung Cancer: Analysis of the Surveillance, Epidemiology, and End Results Data Chest, September 1, 2009; 136(3): 701 - 709. [Abstract] [Full Text] [PDF]

				A. F. Gazdar and J. D. Minna Multifocal Lung Cancers--Clonality vs Field Cancerization and Does It Matter? J Natl Cancer Inst, April 15, 2009; 101(8): 541 - 543. [Full Text] [PDF]

				V. Baysungur, E. Okur, L. Tuncer, and S. Halezeroglu Sequential right upper sleeve lobectomy and left pneumonectomy for bilateral synchronous lung cancer Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 743 - 744. [Abstract] [Full Text] [PDF]

				P. De Leyn, J. Moons, J. Vansteenkiste, E. Verbeken, D. Van Raemdonck, P. Nafteux, H. Decaluwe, and T. Lerut Survival after resection of synchronous bilateral lung cancer Eur. J. Cardiothorac. Surg., December 1, 2008; 34(6): 1215 - 1222. [Abstract] [Full Text] [PDF]

				M. Riquet, A. Cazes, K. Pfeuty, U. D. Ngabou, C. Foucault, A. Dujon, and E. Banu Multiple Lung Cancers Prognosis: What About Histology? Ann. Thorac. Surg., September 1, 2008; 86(3): 921 - 926. [Abstract] [Full Text] [PDF]

				I. Orlow, B. J. Park, U. Mujumdar, H. Patel, P. Siu-Lau, B. A. Clas, R. Downey, R. Flores, M. Bains, N. Rizk, et al. DNA Damage and Repair Capacity in Patients With Lung Cancer: Prediction of Multiple Primary Tumors J. Clin. Oncol., July 20, 2008; 26(21): 3560 - 3566. [Abstract] [Full Text] [PDF]

				D. Trousse, X. B. D'Journo, J.-P. Avaro, C. Doddoli, R. Giudicelli, P. A. Fuentes, and P. A. Thomas Multifocal T4 non-small cell lung cancer: a subset with improved prognosis Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 99 - 103. [Abstract] [Full Text] [PDF]

				H. Rostad, T.-E. Strand, A. Naalsund, and J. Norstein Resected Synchronous Primary Malignant Lung Tumors: A Population-Based Study Ann. Thorac. Surg., January 1, 2008; 85(1): 204 - 209. [Abstract] [Full Text] [PDF]