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Published on: May 26, 2023
Clinical Analysis of 80 Patients of Multiple Primary Lung Cancers Undergoing Simultaneous Video-Assisted
Objective:
To explore the diagnosis, treatment and prognosis of multiple primary lung cancers (MPLCs) through summarizing and analyzing the clinical data of 80 patients with MPLCs.
Methods:
The clinical and pathological data of 80 patients who were diagnosed with MPLCs according to the Martini-Melamed criteria and who underwent simultaneous video-assisted thoracoscopic surgery in our hospital from January 2017 to June 2018 were retrospectively analyzed. The Kaplan-Meier method was used for survival analysis. Log-rank test was used for univariate analysis and Cox proportional hazards regression model for multivariate analysis to evaluate the independent risk factors affecting the prognosis of MPLCs.
Results:
Among the 80 patients, there were 22 cases with MPLCs and 58 cases with double primary lung cancers. The surgical approach was mainly pulmonary lobectomy and pulmonary segmental or wedge resection (41.25%, 33/80), and lesions occurred predominantly in the upper lobe of the right lung (39.8%, 82/206). The pathology of lung cancers was mainly adenocarcinoma (89.8%, 185/206), with invasive adenocarcinoma as a dominant pathological type (68.6%, 127/185), in which acinar subtype was found to be predominant (79.5%, 101/127). The proportion of MPLCs with the same histopathological type (96.3%, 77/80) was higher than that with different histopathological types (3.7%, 3/80). Postoperative pathological staging showed stage I in most patients (86.25%, 69/80). Univariate analysis revealed that the maximum tumor diameter, highest pathological stage and lymph node metastasis were correlated with disease-free survival (P < .05). The overall median survival time of patients was 50 months. Cox multivariate regression analysis indicated that lymph node metastasis was an independent risk factor affecting the prognosis of MPLC patients (P < .05).
Conclusion:
MPLCs occur principally in the upper lobe of the right lung and pulmonary adenocarcinoma is the most dominant pathological type, with acinar type as the predominant pathological subtype. Lymph node metastasis is an independent risk factor affecting the prognosis of MPLC patients. A favorable prognosis can be achieved through early diagnosis and active surgical treatment for individuals who are highly suspected of MPLCs indicated by imaging examination.
