JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (11): 42-46.doi: 10.6040/j.issn.1671-7554.0.2017.141

Previous Articles     Next Articles

Surgical treatment for 61 patients with multiple lung lesions

PENG Yue, FENG Zhen, XIE Hounai, WANG Hui, LI Meng, REN Wangang, LIU Tong, PENG Zhongmin   

  1. Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2017-02-14 Online:2017-11-10 Published:2017-11-10

PDF (PC)

120

Abstract: Objective To provide experiences for clinical diagnosis and treatment by analyzing the surgical outcomes for patients with multiple lung lesions. Methods Clinical data of 61 patients with clinical diagnosis of synchronous multiple primary non-small cell lung cancer(SMPLC)were collected from May 2012 to Apr. 2016 in our hospital. The clinicopathologic features, surgical treatment and overall survival(OS)were retrospectively analyzed. Results Among the 61 patients, 47 patients were verified with more than one malignant tumors. Ten patients were verified with only one malignant tumor, and all lesions of the other 4 patients were benign. Forty-one patients were finally diagnosed with SMPLC after surgical treatment. The 1-year and 3-year OS rates were 97.0% and 77.5%, respectively. Smaller dimension of maximal tumor(χ2=10.918, P=0.012), lesions with less solid ingredient(χ2=10.754, P=0.005), lymph nodes metastases negative(χ2=10.234, P=0.001)and earlier TNM stage(χ2=12.068, P=0.007)were correlated with better OS. Conclusion For patients with multiple lung lesions, if the diagnosis of SMPLC can not be excluded and there is no lymph nodes metastases in thoracic computed tomography, surgical treatment can be considered preferentially.

Key words: Multiple lung lesions, Synchronous primary lung cancer, Surgical treatment, Multiple primary non-small cell lung cancer

CLC Number: 

  • R734.2
[1] Arai J, Tsuchiya T, Oikawa M, et al. Clinical and molecular analysis of synchronous double lung cancers[J]. Lung Cancer, 2012, 77(2): 281-287.
[2] Martini N, Melamed MR. Multiple primary lung cancers[J]. J Thorac Cardiovasc Surg, 1975, 70(4): 606-612.
[3] Kozower BD, Larner JM, Detterbeck FC, et al. Special treatment issues in non-small cell lung cancer: diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines[J]. Chest, 2013, 143(5 suppl): e369S-e399S.
[4] Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming(seventh)edition of the TNM classification of malignant tumors[J]. J Thorac Oncol, 2007, 2(8): 706-714.
[5] National Comprehensive Cancer Network.(NCCN)Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer, Version 2. 2017[EB/OL].[2016-10-26] [2017-01-12] https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
[6] Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming(eighth)edition of the TNM classification for lung cancer[J]. J Thorac Oncol, 2016, 11(1): 39-51.
[7] Park CM, Goo JM, Lee HJ, et al. Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up[J]. Radiographics, 2007, 27(2): 391-408.
[8] Fan L, Liu SY, Li QC, et al. Multidetector CT features of pulmonary focal ground-glass opacity: differences between benign and malignant[J]. Br J Radiol, 2012, 85(1015): 897-904.
[9] 周丽娜, 吴宁, 李蒙. 多层螺旋CT对同时多原发肺癌的诊断价值[J]. 癌症进展, 2012, 10(1): 64-68. ZHOU Lina, WU Ning, LI Meng. Diagnostic value of multi-slice spiral CT in synchronous multiple primary lung cancer[J]. Ai Zheng Jin Zhan, 2012, 10(1): 64-68.
[10] Shimizu K, Ikeda N, Tsuboi M, et al. Percutaneous CT-guided fine needle aspiration for lung cancer smaller than 2cm and revealed by ground-glass opacity at CT[J]. Lung Cancer, 2006, 51(2): 173-179.
[11] 高玉军, 李道堂. 肺多发磨玻璃结节处理策略的研究进展[J].中国肿瘤杂志, 2016, 25(7): 529-533. GAO Yujun, LI Daotang. Progress on processing strategy of multiple ground-grass opacity[J]. China Cancer, 2016, 25(7): 529-533.
[12] MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017[J]. Radiology, 2017, 284(1):228-243.
[13] Kim HK, Choi YS, Kim K, et al. Management of ground-glass opacity lesions detected in patients with otherwise operable non-small cell lung cancer[J]. J Thorac Oncol, 2009, 4(10): 1242-1246.
[14] 陈海泉. 多原发非小细胞肺癌的诊断与外科治疗进展[J]. 中华胸部外科电子杂志, 2014, 1(1): 3-7. CHEN Haiquan. Advance on diagnosis and surgical management of multiple primary non-small cell lung cancers[J]. Chin J Thorac Surg(Electronic Edition), 2014, 1(1): 3-7.
[15] Kim HY, Shim YM, Lee KS, et al. Persistent pulmonary nodular ground-glass opacity at thin-Section CT: histopathologic comparisons[J]. Radiology, 2007, 245(1): 267-275.
[16] Takamochi K, Oh S, Matsuoka J, et al. Clonality status of multifocal lung adenocarcinomas based on the mutation patterns of EGFR and K-ras[J]. Lung Cancer, 2012, 75(3): 313-320.
[17] Dai L, Yang HL, Yan WP, et al. The equivalent efficacy of multiple operations for multiple primary lung cancer and a single operation for single primary lung cancer[J]. J Thorac Dis, 2016, 8(5): 855-861.
[18] Ishikawa Y, Nakayama H, Ito H, et al. Surgical treatment for synchronous primary lung adenocarcinomas[J]. Ann Thorac Surg, 2014, 98(6): 1983-1988.
[19] Chang YL, Wu CT, Lee YC. Surgical treatment of synchronous multiple primary lung cancers: experience of 92 patients[J]. J Thorac Cardiovasc Surg, 2007, 134(3): 630-637.
[20] Kocaturk CI, Gunluoglu MZ, Cansever L, et al. Survival and prognostic factors in surgically resected synchronous multiple primary lung cancers[J]. Eur J Cardiothorac Surg, 2011, 39(2): 160-166.
[21] Jung EJ, Lee JH, Jeon K, et al. Treatment outcomes for patients with synchronous multiple primary non-small cell lung cancer[J]. Lung Cancer, 2011, 73(2): 237-242.
[22] Liu M, He W, Yang J, et al. Surgical treatment of synchronous multiple primary lung cancers: a retrospective analysis of 122 patients[J]. J Thorac Dis, 2016, 8(6): 1197-1204.
[23] Slaughter DP, Southwick HW, Smejkal W. “Field cancerization” in oral stratified squamous epithelium. Clinical implications of multicentric origin[J]. Cancer, 1953, 6(5): 963-968.
[24] Zhang Z, Gao S, Mao Y, et al. Surgical outcomes of synchronous multiple primary non-small cell lung cancers[J]. Sci Rep, 2016, 6. DOI: 10.1038/srep23252.
[25] 李营, 金波, 施建新,等. 41例可手术多原发肺癌临床分析[J]. 中国癌症杂志, 2014, 24(9): 700-706. LI Ying, JIN Bo, SHI Jianxin, et al. Clinical analysis of 41 cases with resected multiple primary lung cancers[J]. China Oncology, 2014, 24(9): 700-706.
[26] Trousse D, Barlesi F, Loundou A, et al. Synchronous multiple primary lung cancer: an increasing clinical occurrence requiring multidisciplinary management[J]. J Thorac Cardiovasc Surg, 2007, 133(5): 1193-1200.
[1] Yifeng WANG,Liqing HE. Research progress on surgery of inguinal lymph nodes in vulvar cancer [J]. Journal of Shandong University (Health Sciences), 2021, 59(9): 103-109,116.
[2] HUO Suxia, LIU Wei, WANG Xin. Experience in the treatment of 86 cases of type Ⅲ cesarean scar pregnancy [J]. Journal of Shandong University (Health Sciences), 2021, 59(1): 40-44.
[3] LIU Tao, BAO Feilong, GAO Wei, KANG Shijie, LÜ Fuxin, HU Yiming. A standard surgical protocol and outcome of treating varus posteromedial rotational instability of elbow [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(12): 41-45.
[4] ZHANG Lin1, ZHANG Zhen-jiang2, MENG Long1, MA Wei1, DU Jia-jun1. Surgical treatment for malignant focal ground glass opacity lung nodule [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(9): 84-87.
[5] CAO Wei, XIN Tao, LIU Wei, ZHANG Yong-chao. Clinical analysis of latent cerebrospinal fluid leakage after cerebllopontine angle tumor surgery [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 78-81.
[6] MENG Hai-peng, NIU Wei-bo, WU Xiao-peng, GUO Sen, LIU Yi, CHEN Yu-xin. Effects of type of PVTT on long-term outcomes of  surgical treatment for hepatocellular carcinoma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 61-66.
[7] WEI Sheng-cheng1, WANG Zhi-gang1, QU Chun-cheng1, TENG Liang-zhu2. Imaging characteristics and surgical treatment of Sturge-Weber syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(5): 95-.
[8] YANG Xueyong1, ZHOU Gengxu1, LI Qiuping2, FU Song1, LIU Yuhang1, WANG Hui1, ZHAO Xin2, FENG Zhichun3 . Bedside surgical ligation of patent ductus arteriosus in  low body weight premature infants [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(8): 133-135.
[9] FANG Jian-wei1, LIU Fan-ying1, LI Jun1,2. Clinical characteristics and surgical treatment of pulmonary  sclerosing hemangioma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(2): 83-87.
[10] SUN Yong-hui, ZOU Cheng-wei, LI De-cai, LI Hong-xin, WANG Zheng-jun, ZI Jie, ZHANG Wen-long, ZHANG Hai-zhou, FAN Quan-xin, WANG An-biao. Surgical treatment of Stanford type A aortic dissection [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(1): 71-.
[11] . Surgical treatment of aortopulmonary septal defect [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(11): 121-123.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] SHI Shuang, LI Juan, MI Qi, WANG Yunshan, DU Lutao, WANG Chuanxin. Construction and application of a miRNAs prognostic risk assessment model of gastric cancer[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 47 -52 .
[2] LYU Longfei, LI Lin, LI Shuhai, QI Lei, LU Ming, CHENG Chuanle, TIAN Hui. Application of laparoscopic fine needle catheter jejunostomy in minimally invasive McKeown resection of esophageal cancer[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 77 -81 .
[3] SHAO Haigang, WANG Xuan, WANG Qing. Anatomy of the root canal system of mandibular first premolar in population of Shandong Province[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(9): 85 -89 .
[4] HUANG Fei,WANG Huaijing,XING Yi,GAO Wei,LI Yonggang,XING Ziying,LI Zhenzhong. Protective effects of NGF and GM1 on primary sensory neurons in SD rat with sciatic nerve injury[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(4): 332 -335 .
[5] . [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(10): 1078 -1080 .
[6] TANG Fang1,2, ZHANG Yingqian3, WANG Zhiqiang4, KANG Dianmin4,
WANG Jiezhen1, XUE Fuzhong1. A 2D minimal spanning tree model of the spatial structures of natural focal disease[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(01): 106 -110 .
[7] JIANG Bao-dong,MA Xiang-xing,WANG Qing,WANG Qian,FENG Xiao-yuan,LI Ke,YU Fu-hua. Imaging parameters of multislice spiral CT venography in cerebral veins[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(11): 1084 -1086 .
[8] LI Yu-liang,WANG Yong-zheng,WANG Xiao-hua,ZHANG Fu-jun,ZHU Li-dong,ZHANG Wang-ming,LI Zheng,LI Zhen-jia,ZHANG Kai-xian. I implantation combined with Gemcitabine in the treatment of advanced pancreatic cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(4): 393 -396 .
[9] ZHU Xiaoli1, GUO Shuling1, SU Lei1, FENG Yuxin2, YUAN Fangshu1. Extraction of total proteins from demodex and qualification of their molecular weights[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(5): 58 -62 .
[10] WANG Xiaoju1，　WANG Mingming2，　XU Wansu2,　ZHAO Shengmei3，CUI Sunan2，　LI Xiaoying2，　LIU Chunhua1
. Expression of peripheral blood lymphocyte ubiquitin mRNA in chronic HBV infection with active inflammation and its clinical significance[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(02): 58 -61 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd