title: Survival and prognostic factors in surgically resected synchronous multiple primary lung cancers.
abstract: OBJECTIVE
  The presence of synchronous multiple primary non-small-cell lung cancers (SMPLC) is a rare condition and the optimal treatment remains unclear. In this study, the survival of surgically treated SMPLC patients and the factors affecting survival were analyzed.
  
  
  METHODS
  Between 2001 and 2008, 26 consecutive patients diagnosed with SMPLC, who had all of their tumors resected, were retrospectively evaluated. Patients, who had bronchoalveolar carcinoma or carcinoid tumors and satellite nodules, were excluded. Prognostic factors were analyzed using univariate and multivariate analyses.
  
  
  RESULTS
  The tumors were unilateral in 14 and bilateral in 12 patients. In total, 38 procedures were performed. A complete resection was achieved in 35 (92.1%) procedures. The in-hospital mortality rate was 7.6% (two patients). The overall 5-year survival rate was 49.7%, and the median survival time was 40 months. The 5-year survival rate was 40.6% for unilateral and 62.8% for bilateral SMPLC patients (p = 0.47). Histopathologic tumor type, N1 nodal disease, tumor (T) status, and older age did not influence survival. There was no survival disadvantage for patients, upon whom a sublobar resection had been performed. There was a trend toward poorer survival in patients upon whom a pneumonectomy had been performed (p = 0.12). The 3-year survival rate for patients, who received adjuvant chemotherapy and/or radiotherapy (66.7%), was better than other patients (56.3%). In the multivariate analysis, we found a trend toward poor survival in patients, who received a pneumonectomy, and a trend toward better survival in patients, who received adjuvant therapy (p = 0.05 and p = 0.06).
  
  
  CONCLUSIONS
  The survival of SMPLC patients, who were treated surgically, was satisfactory. Pneumonectomy was a poor prognostic factor, whereas adjuvant therapy was a good prognostic factor.
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, 34760 Zeytinburnu, Istanbul, Turkey. celalettinkocaturk@hotmail.com
authors.forename: Celalettin Ibrahim
authors.initials: CI
authors.lastname: Kocaturk
authors.forename: Mehmet Zeki
authors.initials: MZ
authors.lastname: Gunluoglu
authors.forename: Levent
authors.initials: L
authors.lastname: Cansever
authors.forename: Adalet
authors.initials: A
authors.lastname: Demir
authors.forename: Ulas
authors.initials: U
authors.lastname: Cinar
authors.forename: Seyyit Ibrahim
authors.initials: SI
authors.lastname: Dincer
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Bedirhan
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome