Association of the Extent of Resection with Survival in Multiple Primary Lung Cancer: A Systematic Review

Nicola Tamburini; Cristina Bombardini; Marco Chiappetta; Pio Maniscalco; Giorgia Valpiani; Alfredo Cesario; Roberto Cirocchi; Gabriele Anania; Antonio Stefanelli; Giorgio Cavallesco; Stefano Margaritora; Filippo Lococo

doi:10.1055/s-0042-1742756

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2023; 71(02): 145-158
DOI: 10.1055/s-0042-1742756

Review Article

Association of the Extent of Resection with Survival in Multiple Primary Lung Cancer: A Systematic Review

Authors

Nicola Tamburini

¹Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
Cristina Bombardini

¹Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
Marco Chiappetta

²Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Pio Maniscalco

¹Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
Giorgia Valpiani

³Research Innovation Quality and Accreditation Unit, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
Alfredo Cesario

²Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Roberto Cirocchi

⁴Department of General Surgery, University of Perugia, Perugia, Italy
Gabriele Anania

¹Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
Antonio Stefanelli

⁵Department of Radiation Oncology, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
Giorgio Cavallesco

¹Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
Stefano Margaritora

²Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Filippo Lococo

²Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

Abstract

Alle Artikel dieser Rubrik

Abstract

Background The incidence of synchronous multiple primary lung cancer (SMPLC) has progressively increased, due to recent advances in imaging. To date, no guidelines defining recommendations for patients' selection and no standard treatment of cases with SMPLC have been defined.

The primary aim of this systematic review was to assess survival among patients treated with lobectomy or sublobar resection MPLC.

Methods Comprehensive literature search of Medline, the Cochrane Library, reference lists, and ongoing studies was performed according to a prospectively registered design (PROSPERO: CRD42019115487). All studies published between 1998 and December 2020 that examined treatments with lobectomy compared to sublobar resection were included. Two double-blind investigators independently selected articles.

Primary outcomes were to assess the 5-year overall survival (OS) rate among patients treated with lobectomy or sublobar resection and the impact of lymph node status on 5-year OS and 5-year disease-free survival in patients with MPLC.

Results The search yielded 424 articles; 4 observational studies met the inclusion criteria and collectively evaluated 298 patients with a mean age ranging from 61.5 to 67 years. A total of 112 patients were treated for bilateral synchronous tumors and 186 patients for unilateral multiple synchronous tumors. All included studies showed that the type of resection, lobectomy or limited resection, had no significant impact on survival.

Conclusion Limited resection is a valuable treatment option for MPLC. However, the clinical level of evidence of the studies found is low and randomized studies are needed to clarify the extent of resection in MPLC.

Keyword

lung cancer treatment (surgery medical) - thoracoscopy/VATS - surgery - complications - lung cancer - diagnosis

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Referenzen

References
1 Henschke CI, McCauley DI, Yankelevitz DF. et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354 (9173): 99-105
2 Carey FA, Donnelly SC, Walker WS, Cameron EW, Lamb D. Synchronous primary lung cancers: prevalence in surgical material and clinical implications. Thorax 1993; 48 (04) 344-346
3 Jung EJ, Lee JH, Jeon K. et al. Treatment outcomes for patients with synchronous multiple primary non-small cell lung cancer. Lung Cancer 2011; 73 (02) 237-242
4 Kwan A, Seltzer M, Czernin J, Chou MJ, Kao CH. Characterization of hilar lymph node by 18F-fluoro-2-deoxyglucose positron emission tomography in healthy subjects. Anticancer Res 2001; 21 (1B): 701-706
5 Shen KR, Meyers BF, Larner JM, Jones DR. American College of Chest Physicians. Special treatment issues in lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132 (3, Suppl): 290S-305S
6 Rostad H, Strand TE, Naalsund A, Norstein J. Resected synchronous primary malignant lung tumors: a population-based study. Ann Thorac Surg 2008; 85 (01) 204-209
7 Fonseca A, Detterbeck FC. How many names for a rose: inconsistent classification of multiple foci of lung cancer due to ambiguous rules. Lung Cancer 2014; 85 (01) 7-11
8 Yao F, Yang H, Zhao H. Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules. J Thorac Dis 2016; 8 (03) 469-475
9 Altorki NK, Yip R, Hanaoka T. et al; I-ELCAP Investigators. Sublobar resection is equivalent to lobectomy for clinical stage 1A lung cancer in solid nodules. J Thorac Cardiovasc Surg 2014; 147 (02) 754-762 , Discussion 762–764
10 Shimada Y, Saji H, Otani K. et al. Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions. Lung Cancer 2015; 88 (02) 174-180
11 Tanvetyanon T, Robinson L, Sommers KE. et al. Relationship between tumor size and survival among patients with resection of multiple synchronous lung cancers. J Thorac Oncol 2010; 5 (07) 1018-1024
12 Riquet M, Cazes A, Pfeuty K. et al. Multiple lung cancers prognosis: what about histology?. Ann Thorac Surg 2008; 86 (03) 921-926
13 Deschamps C, Pairolero PC, Trastek VF, Payne WS. Multiple primary lung cancers. Results of surgical treatment. J Thorac Cardiovasc Surg 1990; 99 (05) 769-777 , discussion 777–778
14 Battafarano RJ, Meyers BF, Guthrie TJ, Cooper JD, Patterson GA. Surgical resection of multifocal non-small cell lung cancer is associated with prolonged survival. Ann Thorac Surg 2002; 74 (04) 988-993 , discussion 993–994
15 Chang Y-L, Wu C-T, Lee Y-C. Surgical treatment of synchronous multiple primary lung cancers: experience of 92 patients. J Thorac Cardiovasc Surg 2007; 134 (03) 630-637
16 Tsunezuka Y, Matsumoto I, Tamura M. et al. The results of therapy for bilateral multiple primary lung cancers: 30 years experience in a single centre. Eur J Surg Oncol 2004; 30 (07) 781-785
17 Fabian T, Bryant AS, Mouhlas AL, Federico JA, Cerfolio RJ. Survival after resection of synchronous non-small cell lung cancer. J Thorac Cardiovasc Surg 2011; 142 (03) 547-553
18 Finley DJ, Yoshizawa A, Travis W. et al. Predictors of outcomes after surgical treatment of synchronous primary lung cancers. J Thorac Oncol 2010; 5 (02) 197-205
19 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62 (10) 1006-1012
20 Jadad AR, Moore RA, Carroll D. et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17 (01) 1-12
21 Wells GA, Shea B, O'Connell D. et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses,. 2011
22 De Leyn P, Moons J, Vansteenkiste J. et al. Survival after resection of synchronous bilateral lung cancer. Eur J Cardiothorac Surg 2008; 34 (06) 1215-1222
23 Yu YC, Hsu PK, Yeh YC. et al. Surgical results of synchronous multiple primary lung cancers: similar to the stage-matched solitary primary lung cancers?. Ann Thorac Surg 2013; 96 (06) 1966-1974
24 Liu M, He W, Yang J, Jiang G. Surgical treatment of synchronous multiple primary lung cancers: a retrospective analysis of 122 patients. J Thorac Dis 2016; 8 (06) 1197-1204
25 Voltolini L, Rapicetta C, Luzzi L. et al. Surgical treatment of synchronous multiple lung cancer located in a different lobe or lung: high survival in node-negative subgroup. Eur J Cardiothorac Surg 2010; 37 (05) 1198-1204
26 Clavien PA, Barkun J, de Oliveira ML. et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250 (02) 187-196
27 Toufektzian L, Attia R, Veres L. Does the extent of resection affect survival in patients with synchronous multiple primary lung cancers undergoing curative surgery?. Interact Cardiovasc Thorac Surg 2014; 19 (06) 1059-1064
28 Chen TF, Xie CY, Rao BY. et al. Surgical treatment to multiple primary lung cancer patients: a systematic review and meta-analysis. BMC Surg 2019; 19 (01) 185
29 Jiang L, He J, Shi X. et al. Prognosis of synchronous and metachronous multiple primary lung cancers: systematic review and meta-analysis. Lung Cancer 2015; 87 (03) 303-310
30 Trousse D, Barlesi F, Loundou A. et al. Synchronous multiple primary lung cancer: an increasing clinical occurrence requiring multidisciplinary management. J Thorac Cardiovasc Surg 2007; 133 (05) 1193-1200
31 Kocaturk CI, Gunluoglu MZ, Cansever L. et al. Survival and prognostic factors in surgically resected synchronous multiple primary lung cancers. Eur J Cardiothorac Surg 2011; 39 (02) 160-166
32 Ettinger DS, Wood DE, Aisner DL. et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 2.2021. J Natl Compr Canc Netw 2021; 19 (03) 254-266
33 Lim E, Baldwin D, Beckles M. et al; British Thoracic Society, Society for Cardiothoracic Surgery in Great Britain and Ireland. Guidelines on the radical management of patients with lung cancer. Thorax 2010; 65 (Suppl. 03) iii1-iii27
34 Nakamura H, Kawasaki N, Taguchi M, Kabasawa K. Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis. Br J Cancer 2005; 92 (06) 1033-1037
35 Fan J, Wang L, Jiang GN, Gao W. Sublobectomy versus lobectomy for stage I non-small-cell lung cancer, a meta-analysis of published studies. Ann Surg Oncol 2012; 19 (02) 661-668
36 Ijsseldijk MA, Shoni M, Siegert C. et al. Oncological outcomes of lobar resection, segmentectomy, and wedge resection for T1a non-small-cell lung carcinoma: a systematic review and meta-analysis. Semin Thorac Cardiovasc Surg 2020; 32 (03) 582-590
37 Khullar OV, Liu Y, Gillespie T. et al. Survival after sublobar resection versus lobectomy for clinical stage IA lung cancer: an analysis from the National Cancer Data Base. J Thorac Oncol 2015; 10 (11) 1625-1633
38 Zhang Y, Sun Y, Wang R, Ye T, Zhang Y, Chen H. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stage I non-small cell lung cancer. J Surg Oncol 2015; 111 (03) 334-340
39 Roman M, Labbouz S, Valtzoglou V. et al. Lobectomy vs. segmentectomy. A propensity score matched comparison of outcomes. Eur J Surg Oncol 2019; 45 (05) 845-850
40 Whitson BA, Groth SS, Andrade RS, Maddaus MA, Habermann EB, D'Cunha J. Survival after lobectomy versus segmentectomy for stage I non-small cell lung cancer: a population-based analysis. Ann Thorac Surg 2011; 92 (06) 1943-1950

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