Rostad Hans, Strand Trond-Eirik, Naalsund Anne, Norstein Jarle
Cancer Registry of Norway, Montebello, Oslo, Norway.
Ann Thorac Surg. 2008 Jan;85(1):204-9. doi: 10.1016/j.athoracsur.2007.07.091.
Synchronous lung tumors with a histology indicating primary lung carcinomas detected preoperatively or at surgery may represent intrapulmonary metastases from a primary tumor or two or more simultaneously occurring primary tumors. The situation is rare. This study was conducted to assess the characteristics and outcome for this patient group.
All clinical and pathology departments in Norway submit standardized reports on cancer patients to the Cancer Registry of Norway. The registry also has a law-regulated authority to collect supplemental information on diagnosis, treatment, and outcome for all cancer patients from hospitals. During the period 1993 to 2000, lung cancer was diagnosed in 15,308 patients, of whom 2528 underwent resection in 24 hospitals. This investigation included all patients with histology demonstrating primary lung carcinoma in more than one tumor in the resected specimen.
Synchronous malignant tumors were found in 94 patients: 66 had two tumors and the remaining 28 had three or more. The tumors were of similar histology in 85 cases. The tumors were diagnosed preoperatively in 11 patients and peroperatively or in the resected specimen in the other 83. The 5-year relative survival rate was 31.4% for patients with squamous cell carcinomas, 23.2% for adenocarcinomas, and 42.7% for patients with tumors of other histology (two carcinoids).
Survival in patients with synchronous lung tumors is good compared with historical reports on patients with distant metastases or other variants of T4 tumors; thus, they should be considered for surgery.
术前或手术时发现组织学检查提示为原发性肺癌的同步性肺肿瘤，可能代表原发性肿瘤的肺内转移或两个或更多同时发生的原发性肿瘤。这种情况很罕见。本研究旨在评估该患者群体的特征和预后。
挪威所有临床和病理科室都向挪威癌症登记处提交癌症患者的标准化报告。该登记处还拥有法律规定的权力，可从医院收集所有癌症患者的诊断、治疗和预后补充信息。在1993年至2000年期间，15308例患者被诊断为肺癌，其中2528例在24家医院接受了手术切除。本研究纳入了所有切除标本中组织学显示一个以上肿瘤为原发性肺癌的患者。
94例患者发现同步性恶性肿瘤：66例有两个肿瘤，其余28例有三个或更多肿瘤。85例患者的肿瘤组织学相似。11例患者术前诊断出肿瘤，另外83例在手术中或切除标本中诊断出肿瘤。鳞状细胞癌患者的5年相对生存率为31.4%，腺癌患者为23.2%，其他组织学类型（两个类癌）患者为42.7%。
与远处转移患者或T4肿瘤其他变体的历史报告相比，同步性肺肿瘤患者的生存率较好；因此，应考虑对他们进行手术治疗。
