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Background: The tumor-node-metastasis classification system has proposed that lung cancers presenting as multifocal ground-glass nodules (multi-GGN) on computed tomography scan should be staged as multiple primaries instead of intrapulmonary metastases. However, the problem still exists for those synchronous multiple lung adenocarcinomas (SMLA) involving solid lesions. This study aimed to explore the distinct features of SMLA to better define the diagnosis and staging of this disease.

Methods: Between 2008 and 2016, consecutive patients with complete resection of SMLA were prospectively enrolled in the study. The patients were divided into three groups based on CT images as follows: multi-GGN, one solid nodule plus one or more GGNs (solid-GGN), and multiple solid lesions with or without GGN (multi-solid). Clinicopathologic features and survival outcomes were compared between these groups. Multivariate Cox proportional hazards analyses using bootstrap internal validation were performed to identify independent predictors for recurrence-free survival (RFS) and overall survival (OS).

Results: Of the 695 patients who met the inclusion criteria, 486 (69.9%) presented with multi-GGN tumor, 124 (17.9%) with solid-GGN tumor, and 85 (12.2%) with multi-solid tumor. The three groups had distinguished clinicopathologic features of gender, smoking history, nodal metastases, tumor size, subtype, and location (all P < 0.001). Multivariate analyses demonstrated that multi-solid tumor was an independent predictor for both decreased RFS [hazard ratio (HR) 2.941; 95% confidence interval (CI) 1.07-8.08; P = 0.036] and poor OS (HR 6.13; 95% CI 1.15-32.63; P = 0.034), but neither RFS (P = 0.384) nor OS (P = 0.811) differed between solid-GGN and multi-GGN tumors.

Conclusions: Both multi-GGN and solid-GGN tumors should be staged as multiple primaries, whereas multi-solid tumor was indicated to be advanced disease.

Titel:	Imaging Features Suggestive of Multiple Primary Lung Adenocarcinomas.
Autor/in / Beteiligte Person:	Zhang, Y ; Li, G ; Li, Y ; Liu, Q ; Yu, Y ; Ma, Y ; Pan, Y ; Hu, H ; Sun, Y ; Xiang, J ; Chen, H
Link:	Full Text Finder (Volltext)
Zeitschrift:	Annals of surgical oncology, Jg. 27 (2020-06-01), Heft 6, S. 2061-2070
Veröffentlichung:	2005- : New York, NY : Springer ; <i>Original Publication</i>: New York, NY : Raven Press, c1994-, 2020
Medientyp:	academicJournal
ISSN:	1534-4681 (electronic)
DOI:	10.1245/s10434-019-08109-w
Schlagwort:	Adenocarcinoma pathology Adenocarcinoma of Lung mortality Aged China Disease-Free Survival Female Humans Lung Neoplasms pathology Male Middle Aged Neoplasm Staging Neoplasms, Multiple Primary mortality Neoplasms, Multiple Primary pathology Proportional Hazards Models Retrospective Studies Tomography, X-Ray Computed Adenocarcinoma of Lung diagnostic imaging Adenocarcinoma of Lung pathology Neoplasms, Multiple Primary diagnostic imaging
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Ann Surg Oncol] 2020 Jun; Vol. 27 (6), pp. 2061-2070. <i>Date of Electronic Publication: </i>2019 Dec 20. MeSH Terms: Adenocarcinoma of Lung / diagnostic imaging ; Adenocarcinoma of Lung / pathology ; Neoplasms, Multiple Primary / *diagnostic imaging ; Adenocarcinoma / pathology ; Adenocarcinoma of Lung / mortality ; Aged ; China ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms / pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary / mortality ; Neoplasms, Multiple Primary / pathology ; Proportional Hazards Models ; Retrospective Studies ; Tomography, X-Ray Computed References: Ishikawa Y, Nakayama H, Ito H, et al. Surgical treatment for synchronous primary lung adenocarcinomas. Ann Thorac Surg. 2014;98:1983–8. (PMID: 10.1016/j.athoracsur.2014.07.006) ; Zhang Y, Hu H, Wang R, et al. 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(PMID: 10.1245/s10434-015-5043-9) Grant Information: 2017ZZ02025 Shanghai Municipal Health Commission Key Discipline Project; 2017ZZ01019 Shanghai Municipal Health Commission Key Discipline Project; 81572253 The National Natural Science Foundation of China; SHDC12017102 Shanghai Shenkang Hospital Development Center City Hospital Emerging Cutting-edge Technology Joint Research Project Entry Date(s): Date Created: 20191222 Date Completed: 20210202 Latest Revision: 20210706 Update Code: 20231215

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Imaging Features Suggestive of Multiple Primary Lung Adenocarcinomas.