[Surgical treatment for bilateral multiple lung cancers].

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Context:

• Bilateral multiple bronchogenic carcinomas present unique surgical challenges.
• Synchronous and metachronous presentations require distinct treatment strategies.
• Evaluating surgical outcomes for bilateral lung cancer is crucial for patient management.

Purpose:

• To review surgical approaches and outcomes for patients with bilateral multiple bronchogenic carcinomas.
• To assess the safety and efficacy of different surgical techniques, including lobectomy and thoracoscopic wedge resection.
• To identify optimal treatment strategies for synchronous and metachronous bilateral lung cancers.

Summary:

• A review of 21 patients with bilateral multiple bronchogenic carcinomas (11 synchronous, 10 metachronous) detailed various surgical interventions.
• Treatments included synchronous median sternotomy with lobectomy/wedge resection and metachronous procedures like bilateral lobectomy, segmentectomy, pneumonectomy, and thoracoscopic wedge resection.
• Two patients undergoing bilateral lobectomy experienced mortality due to pulmonary edema and respiratory failure, respectively.

Impact:

• Bilateral lobectomy for bilateral lung cancer is associated with a high mortality rate (10%) and is generally not recommended.
• Limited resection, particularly thoracoscopic wedge resection, should be considered for contralateral primary lung cancers.
• This study informs surgical decision-making for complex bilateral lung cancer cases, emphasizing less invasive approaches for improved outcomes.