Surgical Therapy for Bilateral Multiple Primary Lung Cancer

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Increasing incidence of multiple pulmonary nodules detected by advanced diagnostics.
• Controversial management strategies for patients with multiple primary lung cancer.

Purpose of the Study:

• To evaluate the prognosis of patients undergoing surgical treatment for bilateral multiple primary lung cancer (BMPLC).
• To assess the impact of limited resection on survival in early-stage BMPLC.
• To identify prognostic predictors in BMPLC patients.

Main Methods:

• Retrospective review of patients with BMPLC treated between 2001 and 2014.
• Analysis of surgical procedures: bilateral lobectomies, lobectomies with contralateral sublobar resections, and bilateral sublobar resections.
• Statistical analysis including Cox multivariate analysis for survival predictors.

Main Results:

• Overall 3- and 5-year survival rates were 84.5% and 75.0%, respectively.
• Limited resection for contralateral nodules in stage I BMPLC showed no negative effect on 5-year survival (p = 0.752).
• Advanced TNM stage (p = 0.018) and number of lesions (p = 0.001) were significant predictors of overall survival.

Conclusions:

• Bilateral surgical treatment for BMPLC with curative intent yields promising survival rates.
• Limited resection for contralateral nodules in stage I BMPLC is a safe approach regarding survival.
• Postoperative TNM staging is a reliable indicator of prognosis in BMPLC.