Tian He, Bai Guangyu, Yang Zhenlin, Chen Ping, Xu Jiachen, Liu Tiejun, Fan Tao, Wang Bingning, Xiao Chu, Li Chunxiang, Gao Shugeng, He Jie
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, Yancheng No. 1 People's Hospital, Yancheng, Jiangsu, China.
Front Oncol. 2023 Feb 22;13:1034752. doi: 10.3389/fonc.2023.1034752. eCollection 2023.
In recent decades, multiple primary lung cancer (MPLC) has been increasingly prevalent in clinical practice. However, many details about MPLC have not been completely settled, such as understanding the driving force, clinical management, pathological mechanisms, and genomic architectures of this disease. From the perspective of diagnosis and treatment, distinguishing MPLC from lung cancer intrapulmonary metastasis (IPM) has been a clinical hotpot for years. Besides, compared to patients with single lung lesion, the treatment for MPLC patients is more individualized, and non-operative therapies, such as ablation and stereotactic ablative radiotherapy (SABR), are prevailing. The emergence of next-generation sequencing has fueled a wave of research about the molecular features of MPLC and advanced the NCCN guidelines. In this review, we generalized the latest updates on MPLC from definition, etiology and epidemiology, clinical management, and genomic updates. We summarized the different perspectives and aimed to offer novel insights into the management of MPLC.
近几十年来,多原发性肺癌(MPLC)在临床实践中日益普遍。然而,关于MPLC的许多细节尚未完全明确,例如对该疾病的驱动因素、临床管理、病理机制和基因组结构的认识。从诊断和治疗的角度来看,多年来将MPLC与肺癌肺内转移(IPM)区分开来一直是临床热点。此外,与单发性肺病变患者相比,MPLC患者的治疗更具个体化,消融和立体定向消融放疗(SABR)等非手术治疗方法较为流行。新一代测序技术的出现推动了一波关于MPLC分子特征的研究,并推进了NCCN指南。在本综述中,我们从定义、病因和流行病学、临床管理以及基因组更新等方面总结了MPLC的最新进展。我们总结了不同的观点,旨在为MPLC的管理提供新的见解。