Surgical Treatments for Multiple Primary Adenocarcinoma of the Lung

Nakata, Masao; Shibata, Shigeki; Yamashita, Motohiro; Saya, Hideyuki; Kurita, Akira; Takashima, Shigemitsu; Tanemoto, Kazuo

doi:10.1016/j.athoracsur.2004.03.102

Cited by 142 publications

(112 citation statements)

References 26 publications

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“…The possible causes of this variability could be the challenges in diagnosing SLC, the inclusion of bronchoalveolar carcinoma cases, N2 tumor cases, carcinoid tumor cases and satellite nodule cases in some studies, the shortcomings in evaluation due to the limited number of cases, or the fact that the second cancer is actually metastasis in some patients (23)(24)(25)(26).…”

Section: Synchronous Lung Cancermentioning

confidence: 99%

“…The recommended time period between two surgeries is 4-6 weeks. However, a patient's performance, the morbidities developing after the first surgery, and the surgeon's opinion might change this time period (24,25,41).…”

Section: Synchronous Lung Cancermentioning

confidence: 99%

“…Similarly, both sides requiring sleeve resection might change the order of priority. Briefly, it would be appropriate to evaluate each patient individually instead of obeying the rules at this point (24).…”

Section: Synchronous Lung Cancermentioning

confidence: 99%

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Synchronous, Metachronous or Metastases?

Kocatürk¹

2018

Eur J Ther

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Multiple primer lung cancer (MPAK) satellite tumors (accessory tumor of the same type with the same tumor in the same lobe) synchronous tumors (at the time of diagnosis, or at the same site within 3 months or with other tumors in the opposite lung) and metachronous tumors (a newly developed tumor in a patient with a definitively treated tumor). Satellite tumors are synchronous tumors also. It may be difficult to understand whether MPAC is primer tumors originating from different areas of the lung, or whether they are metastases from each other. If the histopathological types of the tumors are different from each other, it can be said that they are generally MPAK. However, if histopathological types are the same, histopathological, molecular, genetic and clinical data are needed. It is useful to demonstrate histopathologically that the detailed analysis of tumors (subtype, dominant type, especially in adenocarcinomas) and carcioma insitu background. Genetic and molecular tests are still a matter of debate. It is both very expensive and can be performed in a small number of centers, and not at the expected activity. Because the cancer cells are very complex and constantly undergoing mutation and change. The clinical criteria, especially the Martini-Melamed criteria have been used for a long time. It is still valid. If the histopathological types are different for metachronous tumors, there is no problem, but if they are the same, the second tumor is defined according to the development time. However, it may be more accurate to evaluate these patients independently from time to time. The best survival data is obtained with surgery even if it is second cancer or local recurrence or metachronous cancer Therefore, if patients with synchronous or metachronous cancer are considered to have no distant metastasis or mediastinal involvement, surgical treatment should be the priority.

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Section: Synchronous Lung Cancermentioning

confidence: 99%

Section: Synchronous Lung Cancermentioning

confidence: 99%

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Synchronous, Metachronous or Metastases?

Kocatürk¹

2018

Eur J Ther

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“…It is recognised that wedge resection does not constitute an adequate lung cancer operation in most patients with lung cancer, but this may represent an acceptable option in patients with poor pulmonary function and no other alternative, or in Asian patients with multiple peripheral ground-glass type adenocarcinomas ,20 mm [19,51,52]. In the absence of data proving the benefit of wedge resections, these procedures should be avoided as much as possible and the surgeon should always try to perform a systematic lymph node dissection concomitantly in order to obtain an adequate staging.…”

Section: Types Of Procedures and Approachesmentioning

confidence: 99%

“…Considering the multifocal nature of these lesions and the risk of further lesions developing subsequently, it has been suggested that sublobar resections are considered in these patients to spare lung function and allow multiple reoperations. The role of VATS lobectomy and segmentectomy, as well as single-stage bilateral surgical procedures has been emphasised in these patients [51,52]. In the era of effective targeted therapy, extended procedures should be used carefully, especially in patients with sensitising EGFR mutations.…”

Section: Surgery For Early Stage Lung Cancer (Stage I and Ii)mentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

Eur Respir Rev

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Management of Multifocal Bronchioloalveolar Carcinoma (BAC)

West¹

2014

Lung Cancer

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Surgical Treatments for Multiple Primary Adenocarcinoma of the Lung

Cited by 142 publications

References 26 publications

Synchronous, Metachronous or Metastases?

Synchronous, Metachronous or Metastases?

Surgery for nonsmall cell lung cancer

Management of Multifocal Bronchioloalveolar Carcinoma (BAC)

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