Expert consensus on the treatment of early-stage multiple primary lung cancers_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 Thoracic Surgery Branch of Shanghai Medical Association, Thoracic Surgery Branch of Shanghai Medical Doctor Association, Professional Alliance for Promotion and Improvement of Clinical Ability of General Thoracic Surgery

Department of Thoracic Surgery, Shanghai Pulmonary Hospital Affiliated Tongji University, Shanghai, 200433, P. R. China;

Corresponding?author：

Thoracic Surgery Branch of Shanghai Medical Association, Thoracic Surgery Branch of Shanghai Medical Doctor Association, Professional Alliance for Promotion and Improvement of Clinical Ability of General Thoracic Surgery, Email: chenthoracic@163.com

Keywords：

Early-stage lung cancer; multiple primary lung cancers; expert consensus

DOI：

10.7507/1007-4848.202210015

Video：

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Abstract Full text Figures/Tables Video References Cited by

In recent years, the detection rate of multiple primary lung cancers has been increasing year by year. However, there existed discrepance in cognition and treatment modalities for multiple primary early lung cancers among different physicians, which affects the standardized treatment for early-stage multiple primary lung cancers. Therefore, based on a thorough review of domestic and foreign literature, our team proposes this expert consensus focusing on the treatment of early-stage multiple primary lung cancers in China, aiming at providing reference for physicians in early-stage multiple primary lung cancers' treatment and further improving the level of standardized diagnosis and therapy of lung cancer in China.

Citation： Thoracic Surgery Branch of Shanghai Medical Association, Thoracic Surgery Branch of Shanghai Medical Doctor Association, Professional Alliance for Promotion and Improvement of Clinical Ability of General Thoracic Surgery. Expert consensus on the treatment of early-stage multiple primary lung cancers. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(12): 1545-1553. doi: 10.7507/1007-4848.202210015 Copy

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1. 侯晶晶, 王慧娟, 張國偉, 等. 多原發肺癌的診斷與治療. 中國肺癌雜志, 2015, 18(12): 764-769.
2. Lv J, Zhu D, Wang X, et al. The value of prognostic factors for survival in synchronous multifocal lung cancer: A retrospective analysis of 164 patients. Ann Thorac Surg, 2018, 105(3): 930-936.
3. Xiao F, Liu D, Guo Y, et al. Survival rate and prognostic factors of surgically resected clinically synchronous multiple primary non-small cell lung cancer and further differentiation from intrapulmonary metastasis. J Thorac Dis, 2017, 9(4): 990-1001.
4. Chang YL, Wu CT, Lee YC. Surgical treatment of synchronous multiple primary lung cancers: Experience of 92 patients. J Thorac Cardiovasc Surg, 2007, 134(3): 630-637.
5. Adebonojo SA, Moritz DM, Danby CA. The results of modern surgical therapy for multiple primary lung cancers. Chest, 1997, 112(3): 693-701.
6. Miura H, Nakajima N, Takahashi H, et al. Therapeutic strategy for secondary lung cancer. Kyobu Geka, 2010, 63(11): 956-961.
7. Johnson BE. Second lung cancers in patients after treatment for an initial lung cancer. J Natl Cancer Inst, 1998, 90(18): 1335-1345.
8. Lou F, Huang J, Sima CS, et al. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance. J Thorac Cardiovasc Surg, 2013, 145(1): 75-81.
9. Leventakos K, Peikert T, Midthun DE, et al. Management of multifocal lung cancer: Results of a survey. J Thorac Oncol, 2017, 12(9): 1398-1402.
10. Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, version 3. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(5): 497-530.
11. Remon J, Soria JC, Peters S, et al. Early and locally advanced non-small-cell lung cancer: An update of the ESMO clinical practice guidelines focusing on diagnosis, staging, systemic and local therapy. Ann Oncol, 2021, 32(12): 1637-1642.
12. Detterbeck FC, Nicholson AG, Franklin WA, et al. The IASLC lung cancer staging project: Summary of proposals for revisions of the classification of lung cancers with multiple pulmonary sites of involvement in the forthcoming eighth edition of the TNM classification. J Thorac Oncol, 2016, 11(5): 639-650.
13. Martini N, Melamed MR. Multiple primary lung cancers. J Thorac Cardiovasc Surg, 1975, 70(4): 606-612.
14. Mansuet-Lupo A, Barritault M, Alifano M, et al. Proposal for a combined histomolecular algorithm to distinguish multiple primary adenocarcinomas from intrapulmonary metastasis in patients with multiple lung tumors. J Thorac Oncol, 2019, 14(5): 844-856.
15. Ono K, Sugio K, Uramoto H, et al. Discrimination of multiple primary lung cancers from intrapulmonary metastasis based on the expression of four cancer-related proteins. Cancer, 2009, 115(15): 3489-3500.
16. 戴潔, 姜格寧. 多原發肺癌的診治進展. 上海醫學, 2020, 43(7): 439-444.
17. Kozower BD, Larner JM, Detterbeck FC, et al. Special treatment issues in non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e369S-e399S.
18. Girard N, Deshpande C, Lau C, et al. Comprehensive histologic assessment helps to differentiate multiple lung primary nonsmall cell carcinomas from metastases. Am J Surg Pathol, 2009, 33(12): 1752-1764.
19. Detterbeck FC, Franklin WA, Nicholson AG, et al. The IASLC lung cancer staging project: Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(5): 651-665.
20. Thunnissen E, Beasley MB, Borczuk AC, et al. Reproducibility of histopathological subtypes and invasion in pulmonary adenocarcinoma. An international interobserver study. Mod Pathol, 2012, 25(12): 1574-1583.
21. 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2022版). 中華醫學雜志, 2022, 102(23): 1706-1740.
22. Dijkman BG, Schuurbiers OC, Vriens D, et al. The role of (18)F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours. Eur J Nucl Med Mol Imaging, 2010, 37(11): 2037-2047.
23. Liu Y, Tang Y, Xue Z, et al. SUVmax ratio on PET/CT may differentiate between lung metastases and synchronous multiple primary lung cancer. Acad Radiol, 2020, 27(5): 618-623.
24. Antakli T, Schaefer RF, Rutherford JE, et al. Second primary lung cancer. Ann Thorac Surg, 1995, 59(4): 863-866.
25. Murphy SJ, Harris FR, Kosari F, et al. Using genomics to differentiate multiple primaries from metastatic lung cancer. J Thorac Oncol, 2019, 14(9): 1567-1582.
26. Murphy SJ, Aubry MC, Harris FR, et al. Identification of independent primary tumors and intrapulmonary metastases using DNA rearrangements in non-small-cell lung cancer. J Clin Oncol, 2014, 32(36): 4050-4058.
27. Chen D, Mei L, Zhou Y, et al. A novel differential diagnostic model for multiple primary lung cancer: Differentially-expressed gene analysis of multiple primary lung cancer and intrapulmonary metastasis. Oncol Lett, 2015, 9(3): 1081-1088.
28. 王繼凡, 張特, 丁翰林, 等. 同時性多原發肺癌與肺內轉移鑒別方法研究進展. 中國肺癌雜志, 2021, 24(5): 365-371.
29. Shen C, Wang X, Tian L, et al. "Different trend" in multiple primary lung cancer and intrapulmonary metastasis. Eur J Med Res, 2015, 20(1): 17.
30. 韓連奎, 高樹庚, 譚鋒維, 等. 同時性多原發肺癌的診治體會及處理策略新進展. 中國肺癌雜志, 2018, 21(3): 180-184.
31. 支修益, 劉倫旭. 中國胸外科圍手術期氣道管理指南(2020版). 中國胸心血管外科臨床雜志, 2021, 28(3): 251-262.
32. 姜格寧, 陳昶, 朱余明, 等. 上海市肺科醫院磨玻璃結節早期肺腺癌的診療共識(第一版). 中國肺癌雜志, 2018, 21(3): 147-159.
33. Loukeri AA, Kampolis CF, Ntokou A, et al. Metachronous and synchronous primary lung cancers: Diagnostic aspects, surgical treatment, and prognosis. Clin Lung Cancer, 2015, 16(1): 15-23.
34. Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
35. Macchi M, Belfiore MP, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34(5): 96.
36. 葉欣, 王俊, 危志剛, 等. 熱消融治療肺部亞實性結節專家共識(2021年版). 中國肺癌雜志, 2021, 24(5): 305-322.
37. Jones GC, Kehrer JD, Kahn J, et al. Primary treatment options for high-risk/medically inoperable early stage NSCLC patients. Clin Lung Cancer, 2015, 16(6): 413-430.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Expert consensus on the treatment of early-stage multiple primary lung cancers

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