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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 378-385, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MK Ferguson, TR DeMeester, J DesLauriers, AG Little, M Piraux and H Golomb
The findings in 28 patients with synchronous lung cancers are reviewed.
Mediastinoscopy and systemic staging were performed to exclude the
possibilities that one pulmonary lesion was metastatic from the other or
that both represented systemic metastases from another tumor. Nineteen
patients underwent resection of both tumors. Median survival was 25 months
for four patients with definite Stage I synchronous cancers (no nodal
involvement; different cell types, bronchoscopically separate endobronchial
lesions or arising from separate foci of carcinoma in situ) and was 27
months for seven patients with possible synchronous Stage I cancers (no
nodal involvement; similar cell types; located in separate lobes). Median
survival was 11 months for 16 patients having Stage II or III lung cancer
accompanied by a second synchronous lung cancer. In the absence of hilar or
mediastinal nodal involvement and systemic metastases, synchronous tumors
should be considered separate primaries when located in different lobes,
even if they have similar histologic features. Prognosis of synchronous
cancers is related to the presence or absence of nodal metastases.
Pneumonectomy is the operation of choice for synchronous unilateral tumors.
With bilateral tumors, sequential resection starting with the most advanced
lesion is appropriate. Preservation of lung tissue without compromising the
cancer operation is critical.
ARTICLES
Diagnosis and management of synchronous lung cancers
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