title: Pulmonary Metastases from NSCLC and MPLC (Multiple Primary Lung Cancers): Management and Outcome in a Single Centre Experience.
abstract: BACKGROUND
  This is an institutional review of surgical management of second pulmonary tumours in patients with history of Non-small Cell Lung Cancer (NSCLC) resection according to The American College of Chest Physicians' (ACCP) revision to the Martini and Melamed's criteria for the classification of multiple primary lung cancers (MPLC).
  
  
  METHODS
  All patients who underwent iterative pulmonary resections for pulmonary metastasis (Group A) or MPLC (Group B) between 2006 and 2012 were reviewed and their survivals compared accordingly. The main criteria of insertion in Group B were different histology and the same histology with disease-free interval ≤ 4 years; we excluded loco-regional recurrence in nodes and/or on bronchial stump.
  
  
  RESULTS
  Group A: Twenty patients; Disease free time (DFT) after first operation was 15.2 months (range 2-44). One, two and three years overall survival after second resection was 74%, 29%, 14% respectively. Group B: Thirty-six patients. One, two and three years overall survival was 94%, 81%, and 69% respectively. No statistical differences on outcome were found between the two groups in spite of the apparent worse survival rate for Group A (p=.197).
  
  
  CONCLUSIONS
  A further resection for additional nodules, whether designated as intrapulmonary metastases or second primary NSCLC, can be an appropriate curative strategy in selected patients with unimpaired respiratory function and no evidence of distant metastatic disease. The site, the extent of the second resection, the histology and even the stage are unlikely to be related to survival.
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Stella
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy. Electronic address: giulia.luciano2@unibo.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Luciano
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dell'Amore
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Greco
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Chadi
authors.initials: C
authors.lastname: Ammari
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Giunta
authors.affiliation: Thoracic Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate
keywords: Additional nodules; Lung resection; MPLC; Metachronous; Recurrence; Second primary NSCLC