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. 2024 Apr 10;19(1):200.
doi: 10.1186/s13019-024-02652-8.

The characteristics and prognosis of different disease patterns of multiple primary lung cancers categorized according to the 8th edition lung cancer staging system

Yalong Wang #  1 , Lingling Fang #  1 , Xiao Hu #  2 , Hongliang Wu  3 , Lina Zhou  4 , Qi Xue  5 , Shugeng Gao  5 , Jie He  6
Affiliations

The characteristics and prognosis of different disease patterns of multiple primary lung cancers categorized according to the 8th edition lung cancer staging system

Yalong Wang et al. J Cardiothorac Surg. .

Abstract

Introduction: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Keywords: Lung cancer staging system; Multiple primary lung cancer; Prognosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient selection
Fig. 2
Fig. 2
A Typical radiologic and pathologic features of different kinds of MPLC. B-a Overall survival of MPLC. B-b Comparison of overall survival between multiple ground glass nodules and second primary lung cancer. C Comparison of overall survival between different groups in multiple ground glass nodule patients. D Comparation of overall survival between different groups in second primary lung cancer patients
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