Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China.
J Cardiothorac Surg. 2024 Apr 10;19(1):200. doi: 10.1186/s13019-024-02652-8.
The 8th edition lung cancer staging system was the first to describe the detailed diagnosis and staging of multiple primary lung cancers (MPLC). However, the characteristics and prognosis of MPLC categorized according to the new system have not been evaluated.
We retrospectively analyzed data from surgically treated MPLC patients in a single center from 2011 to 2013 and explored the characteristics and outcomes of different MPLC disease patterns.
In total, 202 surgically treated MPLC patients were identified and classified into different groups according to disease categories and diagnostic time (multifocal ground glass/lepidic (GG/L) nodules: n = 139, second primary lung cancer (SPLC): n = 63, simultaneous MPLC (sMPLC): n = 171, and metachronous MPLC (mMPLC): n = 31). There were significant differences in clinical characteristics between SPLC and GG/L nodule patients and simultaneous and metachronous MPLC patients. The overall 1-, 3-, and 5-year lung cancer-specific survival rates of MPLC were 97.98%, 90.18%, and 82.81%, respectively. Five-year survival was better in patients with multiple GG/L nodules than in those with SPLC (87.94% vs. 71.29%, P < 0.05). Sex was an independent prognostic factor for sMPLC (5-year survival, female vs. male, 88.0% vs. 69.5%, P < 0.05), and in multiple tumors, the highest tumor stage was an independent prognostic factor for all categories of MPLC.
The different disease patterns of MPLC have significantly different characteristics and prognoses. Clinicians should place treatment emphasis on the tumor with the highest stage as it is the main contributor to the prognosis of all categories of MPLC patients.
第八版肺癌分期系统是第一个详细描述多原发性肺癌（MPLC）的诊断和分期的系统。然而，根据新系统分类的 MPLC 的特征和预后尚未得到评估。
我们回顾性分析了 2011 年至 2013 年在一家单中心接受手术治疗的 MPLC 患者的数据，并探讨了不同 MPLC 疾病模式的特征和结局。
共确定了 202 例接受手术治疗的 MPLC 患者，并根据疾病类别和诊断时间将其分为不同的组（多灶性磨玻璃/鳞屑样（GG/L）结节：n=139，第二原发性肺癌（SPLC）：n=63，同时性 MPLC（sMPLC）：n=171，异时性 MPLC（mMPLC）：n=31）。SPLC 患者和 GG/L 结节患者以及同时性和异时性 MPLC 患者之间的临床特征存在显著差异。MPLC 的总 1、3 和 5 年肺癌特异性生存率分别为 97.98%、90.18%和 82.81%。多灶性 GG/L 结节患者的 5 年生存率优于 SPLC 患者（87.94% vs. 71.29%，P<0.05）。性别是 sMPLC 的独立预后因素（5 年生存率，女性 vs. 男性，88.0% vs. 69.5%，P<0.05），在多灶性肿瘤中，肿瘤最高分期是所有 MPLC 类别的独立预后因素。
MPLC 的不同疾病模式具有显著不同的特征和预后。临床医生应将治疗重点放在肿瘤分期最高的肿瘤上，因为这是所有 MPLC 患者预后的主要贡献因素。
