■多达15%的肺癌患者有多个可疑结节。虽然这些结节中的一些可能代表转移性肺癌,其他代表同步多原发性肺癌(SMPLC)。SMPLC的发生率范围从0.8%到8.4%,并且似乎在增加。SMPLC的不一致鉴定对于被误诊为具有肺内转移且未提供基于阶段的治疗的患者可能是有害的。我们试图确定SMPLC在大专院校的当代发病率。
■从2018年1月至2019年9月,对接受肺癌切除术的患者进行回顾性分析。使用改良的Martini-Melamed标准鉴定SMPLC患者。
■在21个月期间,227例患者行肺癌切除术。有47例(20.7%)患者有119例病理证实的SMPLC。大多数患者患有同侧肿瘤(n=24,51.1%),至少有1个腺癌(n=40,85.1%)。考虑到组织学亚型,38例(80.9%)有组织学上明显的肿瘤。4年的总体生存率和癌症特异性生存率分别为86%和90%,分别。与2例SMPLC患者相比,只有3例或3例以上SMPLC患者的4年总体生存率(P=0.002)和癌症特异性生存率(P=0.043)较差。患者人口统计学,组织学,肿瘤位置,最高病理分期不影响生存结局.
■使用严格的包含标准,SMPLC的发生率高于以前的报道.SMPLC患者有良好的生存结果,表明它们表现得像原发性肺癌,不是肺内转移.胸外科医师对SMPLC的认识对于优化该患者人群的预后至关重要。
UNASSIGNED: Up to 15% of lung cancer patients have multiple suspicious nodules. While some of these nodules may represent metastatic lung cancer, others represent synchronous multiple primary lung cancer (SMPLC). The incidence of SMPLC ranges from 0.8% to 8.4% and appears to be increasing. Inconsistent identification of SMPLC can be detrimental for patients who are misdiagnosed as having intrapulmonary metastasis and not offered stage-based treatment. We sought to identify the contemporary incidence of SMPLC at a tertiary institution.
UNASSIGNED: From January 2018 to September 2019, patients who underwent lung cancer resection were retrospectively reviewed. Patients with SMPLC were identified using the modified Martini-Melamed criteria.
UNASSIGNED: During the 21-month period, 227 patients underwent lung cancer resection. There were 47 patients (20.7%) who had 119 pathologically confirmed SMPLC. Most patients had ipsilateral tumors (n = 24, 51.1%) with at least 1 adenocarcinoma (n = 40, 85.1%). Considering histologic subtyping, 38 (80.9%) had histologically distinct tumors. Overall and cancer-specific survival at 4 years was 86% and 90%, respectively. Only patients with 3 or more SMPLC had poor 4-year overall (P = 0.002) and cancer-specific survival (P = 0.043) compared with those with 2 SMPLC. Patient demographics, histology, tumor location, and highest pathologic staging did not affect survival outcomes.
UNASSIGNED: Using a strict inclusion criterion, the incidence of SMPLC is higher than previously reported. SMPLC patients have favorable survival outcomes, suggesting that they behave like primary lung cancer, not intrapulmonary metastasis. Awareness of SMPLC by thoracic surgeons is critical in optimizing outcomes in this patient population.