1
|
Wang Z, Zhang Q, Wang C, Herth FJF, Guo Z, Zhang X. Multiple primary lung cancer: Updates and perspectives. Int J Cancer 2024. [PMID: 38783577 DOI: 10.1002/ijc.34994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/14/2024] [Accepted: 03/28/2024] [Indexed: 05/25/2024]
Abstract
Management of multiple primary lung cancer (MPLC) remains challenging, partly due to its increasing incidence, especially with the significant rise in cases of multiple lung nodules caused by low-dose computed tomography screening. Moreover, the indefinite pathogenesis, diagnostic criteria, and treatment selection add to the complexity. In recent years, there have been continuous efforts to dissect the molecular characteristics of MPLC and explore new diagnostic approaches as well as treatment modalities, which will be reviewed here, with a focus on newly emerging evidence and future perspectives, hope to provide new insights into the management of MPLC and serve as inspiration for future research related to MPLC.
Collapse
Affiliation(s)
- Ziqi Wang
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan International Joint Laboratory of Diagnosis and Treatment for Pulmonary Nodules, Zhengzhou, Henan, China
| | - Quncheng Zhang
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan International Joint Laboratory of Diagnosis and Treatment for Pulmonary Nodules, Zhengzhou, Henan, China
| | - Chaoyang Wang
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan International Joint Laboratory of Diagnosis and Treatment for Pulmonary Nodules, Zhengzhou, Henan, China
| | - Felix J F Herth
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan International Joint Laboratory of Diagnosis and Treatment for Pulmonary Nodules, Zhengzhou, Henan, China
- Department of Pneumology and Critical Care Medicine Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - Zhiping Guo
- Department of Health Management, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Laboratory of Chronic Diseases and Health Management, Zhengzhou, Henan, China
| | - Xiaoju Zhang
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan International Joint Laboratory of Diagnosis and Treatment for Pulmonary Nodules, Zhengzhou, Henan, China
| |
Collapse
|
2
|
Zhang J, Huang Y, Han Y, Dong D, Cao Y, Chen X, Liu D, Cheng X, Sun D, Li H, Zhang Y. Immune microenvironment heterogeneity of concurrent adenocarcinoma and squamous cell carcinoma in multiple primary lung cancers. NPJ Precis Oncol 2024; 8:55. [PMID: 38424363 PMCID: PMC10904822 DOI: 10.1038/s41698-024-00548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
The molecular profiles and tumor immune microenvironment (TIME) of multiple primary lung cancers (MPLCs) presenting as concurrent lung adenocarcinoma (ADC) and squamous cell carcinoma (SQCC) remain unknown. We aimed to clarify these factors. We performed whole-exome sequencing (WES), RNA sequencing (RNA-Seq), and multiplex immunohistochemistry (mIHC) for five patients with concurrent ADC and SQCC. We found the genetic mutations were similar between ADC and SQCC groups. RNA-Seq revealed that the gene expression and pathways enriched in ADC and SQCC groups were quite different. Gene set enrichment analysis (GSVA) showed that nine gene sets were significantly differentially expressed between the ADC and SQCC groups (p < 0.05), with four gene sets relevant to squamous cell features upregulated in the SQCC group and five gene sets upregulated in the ADC group. Reactome enrichment analysis of differentially expressed genes showed that the immune function-related pathways, including programmed cell death, innate immune system, interleukin-12 family signaling, and toll-like receptor 2/4 pathways, etc. were significantly enriched. Transcriptomic TIME analysis, with mIHC in patient specimens and in vivo validation, showed tumor-infiltrating immune cells were significantly more enriched and diverse in ADC, especially CD8 + T cells. Our results revealed that the transcriptomic profiles and TIME features were quite different between ADC and SQCC lesions. ADC lesions exhibited a more active TIME than SQCC lesions in MPLCs.
Collapse
Affiliation(s)
- Jiahao Zhang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Yiheng Huang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Yichao Han
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Dong Dong
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Yuqin Cao
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Xiang Chen
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China
| | - Di Liu
- Genecast Biotechnology Co., Ltd., 88 Danshan Road, Xidong Chuangrong Building, Suite C 1310-1318, Xishan District, Wuxi City, Jiangsu, 214104, China
| | - Xueyan Cheng
- Genecast Biotechnology Co., Ltd., 88 Danshan Road, Xidong Chuangrong Building, Suite C 1310-1318, Xishan District, Wuxi City, Jiangsu, 214104, China
| | - Debin Sun
- Genecast Biotechnology Co., Ltd., 88 Danshan Road, Xidong Chuangrong Building, Suite C 1310-1318, Xishan District, Wuxi City, Jiangsu, 214104, China
| | - Hecheng Li
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China.
| | - Yajie Zhang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, 200025, China.
| |
Collapse
|
3
|
Zhang H, Chen L, Mao F, Li J, Hamaji M, Shimada Y, Koo CW, Song Z, Song L, Lu S. Long-term prognosis analysis of surgical therapy for bilateral synchronous multiple primary lung cancer: a follow-up of 293 cases. J Thorac Dis 2024; 16:1450-1462. [PMID: 38505060 PMCID: PMC10944773 DOI: 10.21037/jtd-23-1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 03/21/2024]
Abstract
Background Bilateral synchronous multiple primary lung cancer (BSMPLC) presents significant clinical challenges due to its unique characteristics and prognosis. Understanding the risk factors that influence overall survival (OS) and recurrence-free survival (RFS) is crucial for optimizing therapeutic strategies for BSMPLC patients. Methods We retrospectively analyzed clinical characteristics and treatment outcomes of 293 patients with BSMPLC who underwent surgical treatment between January 2010 and July 2017. Results The 10-year OS and RFS rates were 96.1% and 92.8%, respectively. Preoperative forced expiratory volume in 1 second (FEV1) ≥70% [hazard ratio (HR), 0.214; 95% confidence interval (CI): 0.053 to 0.857], identical pathology types (HR, 9.726; 95% CI: 1.886 to 50.151), largest pT1 (HR, 7.123; 95% CI: 2.663 to 19.055), and absence of lymphovascular invasion (LVI; HR, 7.021; 95% CI: 1.448 to 34.032) emerged as independent predictors of improved OS. Moreover, the sum of tumor sizes less than or equal to 3 cm (HR, 6.229; 95% CI: 1.411 to 27.502) and absence of pleural invasion (HR, 3.442; 95% CI: 1.352 to 8.759) were identified as independent predictors of enhanced RFS. The presence or absence of residual nodules after bilateral surgery did not influence patients' OS (P=0.987) and RFS (P=0.054). Conclusions Patients with BSMPLC who underwent surgery generally had a favorable prognosis. Whether or not to remove all nodules bilaterally does not affect the patient's long-term prognosis, suggesting the need for an individualized surgical approach.
Collapse
Affiliation(s)
- Hui Zhang
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian Chen
- Rehabilitation Department, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
| | - Feng Mao
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiantiao Li
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Masatsugu Hamaji
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Kashihara, Japan
| | - Yoshihisa Shimada
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Chi Wan Koo
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Zuodong Song
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liwei Song
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shun Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Zhou X, Cai X, Jing F, Li X, Zhang J, Zhang H, Li T. Genomic alterations in oral multiple primary cancers. Int J Oral Sci 2024; 16:13. [PMID: 38368361 PMCID: PMC10874441 DOI: 10.1038/s41368-023-00265-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 02/19/2024] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the predominant type of oral cancer, while some patients may develop oral multiple primary cancers (MPCs) with unclear etiology. This study aimed to investigate the clinicopathological characteristics and genomic alterations of oral MPCs. Clinicopathological data from patients with oral single primary carcinoma (SPC, n = 202) and oral MPCs (n = 34) were collected and compared. Copy number alteration (CNA) analysis was conducted to identify chromosomal-instability differences among oral MPCs, recurrent OSCC cases, and OSCC patients with lymph node metastasis. Whole-exome sequencing was employed to identify potential unique gene mutations in oral MPCs patients. Additionally, CNA and phylogenetic tree analyses were used to gain preliminary insights into the molecular characteristics of different primary tumors within individual patients. Our findings revealed that, in contrast to oral SPC, females predominated the oral MPCs (70.59%), while smoking and alcohol use were not frequent in MPCs. Moreover, long-term survival outcomes were poorer in oral MPCs. From a CNA perspective, no significant differences were observed between oral MPCs patients and those with recurrence and lymph node metastasis. In addition to commonly mutated genes such as CASP8, TP53 and MUC16, in oral MPCs we also detected relatively rare mutations, such as HS3ST6 and RFPL4A. Furthermore, this study also demonstrated that most MPCs patients exhibited similarities in certain genomic regions within individuals, and distinct differences of the similarity degree were observed between synchronous and metachronous oral MPCs.
Collapse
Affiliation(s)
- Xuan Zhou
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Xinjia Cai
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Fengyang Jing
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Xuefen Li
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jianyun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Heyu Zhang
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China.
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Tiejun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China.
| |
Collapse
|
5
|
Yang Y, Pei G, Li M, Ma X, Wang S, Min X, Meng S, Qin J, Wang H, Liu J, Huang Y. Case report: Targeted sequencing facilitates the diagnosis and management of rare multifocal pure ground-glass opacities with intrapulmonary metastasis. Front Oncol 2024; 13:1276095. [PMID: 38322291 PMCID: PMC10846301 DOI: 10.3389/fonc.2023.1276095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Treatments for multiple ground-glass opacities (GGOs) for which the detection rate is increasing are still controversial. Next-generation sequencing (NGS) may provide additional key evidence for differential diagnosis or optimal therapeutic schedules. Case presentation We first reported a rare case in which more than 100 bilateral pulmonary GGOs (91.7% of the GGOs were pure GGOs) were diagnosed as both multiple primary lung cancer and intrapulmonary metastasis. We performed NGS with an 808-gene panel to assess both somatic and germline alterations in tissues and plasma. The patient (male) underwent three successive surgeries and received osimertinib adjuvant therapy due to signs of metastasis and multiple EGFR-mutated tumors. The patient had multiple pure GGOs, and eight tumors of four pathological subtypes were evaluated for the clonal relationship. Metastasis, including pure GGOs and atypical adenomatous hyperplasia, was found between two pairs of tumors. Circulating tumor DNA (ctDNA) monitoring of disease status may impact clinical decision-making. Conclusions Surgery combined with targeted therapies remains a reasonable alternative strategy for treating patients with multifocal GGOs, and NGS is valuable for facilitating diagnostic workup and adjuvant therapy with targeted drugs through tissue and disease monitoring via ctDNA.
Collapse
Affiliation(s)
- Yingshun Yang
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| | - Guotian Pei
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| | - Mingwei Li
- Department of Medicine, Acornmed Biotechnology Co., Ltd, Beijing, China
| | - Xiaoxue Ma
- Department of Medicine, Acornmed Biotechnology Co., Ltd, Beijing, China
| | - Shuai Wang
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| | - Xianjun Min
- Department of Thoracic Surgery, Aerospace 731 Hospital, Beijing, China
| | - Shushi Meng
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| | - Jiayue Qin
- Department of Medicine, Acornmed Biotechnology Co., Ltd, Beijing, China
| | - Huina Wang
- Department of Medicine, Acornmed Biotechnology Co., Ltd, Beijing, China
| | - Jun Liu
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| | - Yuqing Huang
- Department of Thoracic Surgery, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China
| |
Collapse
|
6
|
Zhao K, Xia C, Qiu M, Yang Z, Cui T, Song T, Li S, Mei H, Zheng Y, Wang H. Lobar or sublobar resection for early-stage second primary lung cancer ≤ 3 cm in size: a SEER population-based study. J Cancer Res Clin Oncol 2023; 149:16679-16690. [PMID: 37725243 PMCID: PMC10645613 DOI: 10.1007/s00432-023-05396-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Surgical strategy for second primary lung cancer (SPLC) may be more conservative due to influence of first primary lung cancer (FPLC). The optimal surgical method for SPLC warrants discussion. We aimed to explore a more suitable surgical approach for early-stage (T1-T2N0, ≤ 3 cm) SPLC and provide insights for clinical practice. METHODS A retrospective study was conducted using data from the Surveillance, Epidemiology and End Results database between 2004 and 2018, and data of patients with early-stage SPLC who underwent secondary surgery were collected. Propensity score matching (PSM) reduced potential bias between lobar and sublobar resection groups. The effect of lobar and sublobar resection on overall survival (OS) was assessed in all patients and subgroups. RESULTS A total of 714 patients who met the study entry criteria were enrolled, including 476 patients in the sublobar resection group (66.67%) and 238 patients in the lobar resection group (33.33%). There was no difference in OS between the lobar and sublobar resection groups before and after PSM (P = 0.289) and (P = 0.608), respectively. Subgroup analyses showed that lobar resection achieved a significantly better OS than sublobar resection only in patients with an SPLC tumor size of 2-3 cm (P < 0.05). CONCLUSION The OS of sublobar resection was not significantly different from that of lobar resection for early-stage SPLC. For SPLC with a 2-3 cm tumor size, lobar resection is more advantageous than sublobar resection.
Collapse
Affiliation(s)
- Ke Zhao
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Chunqiu Xia
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Minghan Qiu
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Zhen Yang
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Tingkai Cui
- Department of Maternal, Child and Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Teng Song
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Shuping Li
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Hanwei Mei
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Yang Zheng
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Huaqing Wang
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China.
- The Institute of Translational Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China.
| |
Collapse
|
7
|
Zhao J, Shen Z, Huang Y, Zhao G, Wang W, Yang Y, Zhou C, Ye L. Evaluation of surgical outcomes and prognostic factors of second primary lung cancer based on a systematic review and meta-analysis. BMC Surg 2023; 23:95. [PMID: 37085804 PMCID: PMC10120155 DOI: 10.1186/s12893-023-02003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/11/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Although surgery has been widely applied for SPLC therapy, there is still no uniform treatment approach. Whether SPLC and primary lung cancer have similar prognostic characteristics remains controversial. Herein, based on a systematic review and meta-analysis, we aimed to enucleate the influences of diverse surgical strategies and underlying prognostic factors on the prognosis of patients with both the first primary lung cancer and SPLC underwent surgical resection. METHODS A comprehensive and systematic literature search was implemented in three databases (MEDLINE, EMBASE, and Cochrane), and eligible studies were screened following inclusion and exclusion criteria. Meanwhile, we extracted the hazard ratios (HR) together with 95% confidence intervals (CI) for each prognostic factor, either directly or indirectly, from the enrolled literature. RESULTS Eleven studies (published between 2000 and 2022) were included in this study, including 1,131 SPLC patients. The overall survival (OS) exhibited no difference between patients with lobectomy and sublobar resection after SPLC (HR: 0.87, 95%CI: 0.62-1.21, P = 0.41). The patients after completion pneumonectomy had a poor prognosis (HR: 1.85, 95% CI: 1.34-2.55, P < 0.01). Poor prognostic factors after SPLC surgery included synchronous SPLC (HR: 3.38, 95%CI: 1.53-7.46, P < 0.01), tumor diameter > 2 cm (HR: 2.44, 95%CI: 1.73-3.44, P < 0.01), solid predominant in CT morphology (HR: 3.08, 95% CI: 1.14-8.33, P = 0.03), lymph node metastasis (HR: 2.79, 95%CI: 1.40-5.56), and smoking (HR: 2.37, 95%CI: 1.08-26.82, P < 0.01). Tumor disease-free interval (DFI), tumor histological type, and gender had no impact on the prognosis of patients received SPLC surgery. CONCLUSIONS Patients with SPLC, especially those with poor cardiopulmonary function reserve, should be prioritized for sublobar resection for treatment. These patients should also try to avoid completion pneumonectomy. Patients with synchronous SPLC, tumor diameter > 2 cm, solid predominant in CT morphology, lymph node metastasis, and smoking had a poor prognosis. Meanwhile, SPLC has similar prognostic characteristics with single primary lung cancer. However, the study has some limitations and more evidence is warranted to verify the findings.
Collapse
Affiliation(s)
- Jie Zhao
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Zhenghai Shen
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Yunchao Huang
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Guangqiang Zhao
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Wei Wang
- Department of Thoracic Surgery, Taihe Hospital (Hubei University of Medicine), Shiyan, China
| | - Yantao Yang
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Chen Zhou
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China
| | - Lianhua Ye
- Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China.
| |
Collapse
|
8
|
Shen C, Yuan Y, Che G. New method for discrimination of multiple primary lung cancer and metastatic lung cancer. Thorac Cancer 2022; 13:3239-3241. [PMID: 36288456 PMCID: PMC9715886 DOI: 10.1111/1759-7714.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 01/09/2023] Open
Affiliation(s)
- Cheng Shen
- Department of Thoracic SurgeryWest‐China Hospital, Sichuan UniversityChengduChina
| | - Yong Yuan
- Department of Thoracic SurgeryWest‐China Hospital, Sichuan UniversityChengduChina
| | - Guowei Che
- Department of Lung Cancer CenterWest‐China Hospital, Sichuan UniversityChengduChina
| |
Collapse
|
9
|
Comeau J, Beedupalli K, Jois S. Multiple primary lung cancer tumors with diversified genetic mutations-complications in choosing therapeutic options. CLINICAL AND TRANSLATIONAL DISCOVERY 2022; 2:e123. [PMID: 36532867 PMCID: PMC9757724 DOI: 10.1002/ctd2.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Jill Comeau
- School of Clinical Sciences, College of Pharmacy, University of Louisiana Monroe, Shreveport, LA 71101
| | - Kavitha Beedupalli
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103
| | - Seetharama Jois
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana Monroe, 1800 Bienville Drive, Monroe, LA 71201
| |
Collapse
|
10
|
Hsu HS, Ping-Chung T. Management of pulmonary ground glass opacity: A review of current clinical practice guidelines. FORMOSAN JOURNAL OF SURGERY 2022. [DOI: 10.4103/fjs.fjs_107_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|