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[Surgical Treatment to Bilateral Multiple Primary Lung Cancer Patients]
Yoshio Tsunezuka1, Hideki Fujimori, Nobuhiro Tanaka
1Department of General Thoracic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|February 7, 2021
Summary
Surgical strategies for bilateral multiple primary lung cancer (BMPLC) are debated. Lung-preserving resections are preferred, but bilateral lobectomy is feasible for BMPLC patients with adequate respiratory function.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonology
Background:
- Multiple primary lung cancer (MPLC) is increasing due to advanced detection and improved patient survival.
- Surgical treatment strategies for MPLC, particularly bilateral cases (BMPLC), lack consensus.
Purpose of the Study:
- To discuss surgical strategies for bilateral multiple primary lung cancer (BMPLC).
- To evaluate surgical outcomes and feasibility of different resection types for BMPLC.
Main Methods:
- Retrospective review of 53 patients with BMPLC undergoing curative operations (2007-2019).
- Analysis based on Martini-Melamed criteria and oncogene mutation status.
- Evaluation of resection types (lobectomy, segmentectomy, wedge resection) and survival rates.
Main Results:
- Overall 5-year survival after the second operation was 75.1%.
- Lung-preserving resections (segmentectomy/wedge) were common for the second tumor.
- Bilateral lobectomy was performed in 4 cases with sufficient preoperative respiratory function and no major complications.
Conclusions:
- Surgical procedures preserving lung tissue are favored for BMPLC.
- Bilateral lobectomy is not contraindicated for BMPLC in patients with adequate respiratory function.
- Careful patient selection and preoperative assessment are crucial for successful BMPLC surgery.
