Single-stage surgical treatment of synchronous bilateral multiple lung cancers

The rate of detection of synchronous bilateral multiple lung cancers (SBMLC) has increased. We evaluated applicability and efficacy of single-stage surgical treatment of SBMLC patients encountered in our department.

In a retrospective examination of 674 patients who underwent surgical treatment of primary lung cancers at our department between 1999 and 2004, single-stage surgical treatment was used in 19 patients. Clinical and histologic features, approaches, and outcomes of surgical treatments were studied retrospectively.

The 19 patients (6 men, 13 women) were a median age of 65.8 years (range, 52 to 80 years). At operation, all 11 patients (58%) were women with no history of smoking. Lobectomy and wedge resection on the opposite side were performed in 13 patients, segmentectomy and wedge resection were performed in 1, and bilateral wedge resection was done in 5. Postoperative histopathologic examination revealed that 84 lesions were adenocarcinomas and three were squamous cell carcinomas. All pure ground glass opacities (GGOs) measuring less than 10 mm in diameter on high-resolution computed tomography imaging were diagnosed as bronchioloalveolar carcinoma (BAC) type A or B. No patients died perioperatively. The median postoperative observation period was 44 months. Overall survival rates were 94.7% at 3 years and 75.8% at 5 years. In cases of multifocal BAC after resection, development of new lesions was observed in 4 patients.

Single-stage bilateral surgical treatment of SBMLC yielded satisfactory results in our selected patients; however, appearance of new lesions remains a problem.