Abstract:
Objective To summarize the clinical features of multiple primary lung cancer (MPLC) and analyze the factors affecting its survival.
Methods According to Martini-Melamed criteria, complete clinical data and follow-up data of 25 MPLC patients with different histological types from January 2000 to December 2014 in our hospital were retrospectively analyzed. The Cox regression model was adopted to analyze the prognostic factors.
Results Of the 25 MPLC patients, 23 cases were double primary lung cancer and 2 patients were triple primary lung cancer. The age ranged from 36 to 82 years with the median age of 64 years. The common clinical feature of the 25 patients was lesions arising frequently from right upper lobe (34.6%, 18/52). The main pathological types of 52 lesions was adenocarcinoma (44.2%, 23/52), followed by squamous carcinoma (28.8%, 15/52); the lesions of MPLC showed the imaging features of typical primary lung cancer without signs of hilum lymphatic metastasis and distant metastasis. The 3-year and 5-year survival rate of MPLC patients undergoing surgery was 91.8% (23 cases) and 48.8% (13 cases) respectively, and the median survival time was 58 months. Cox Regression analysis indicated that smoking (
HR=4.118,
P=0.015), Ki-67 high expression (
HR=0.258,
P=0.013) were significantly correlated with poor prognosis of MPLC.
Conclusion The lesions of MPLC predominantly occur in right superior lobe and adenocarcinoma is the main pathological type with all these lesions having the malignant characteristics of primary lung cancer. Early radical resection can contribute to better prognosis.