title: Surgical Therapy for Bilateral Multiple Primary Lung Cancer.
abstract: BACKGROUND
  With the development of diagnostic techniques, the incidence of multiple pulmonary nodules has increased. The management of multiple primary lung cancer patients based on currently established criteria, however, remains controversial.
  
  
  METHODS
  Patients who underwent curative operations for bilateral multiple primary lung cancer (BMPLC) based on the Martini-Melamed criterion between January 2001 and June 2014 were reviewed retrospectively.
  
  
  RESULTS
  Bilateral lobectomies and lobectomies with contralateral sublobar resections were performed in 39 and 49 patients, respectively. Bilateral sublobar resections were performed in the remaining 13 cases. Overall survival at 3 and 5 years was 84.5% and 75.0%, respectively. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival (p = 0.752). Postoperative pathologic diagnosis classified by the most advanced TNM stage appeared to present a good correlation with prognosis in patients with BMPLC. Cox multivariate analysis identified the most advanced TNM stage (p = 0.018) and the number of lesions (p = 0.001) as significant predictors of overall survival.
  
  
  CONCLUSIONS
  The prognosis of patients after bilateral surgical treatment with curative intent for BMPLC was shown to be promising. The use of a limited resection procedure for the contralateral second nodule in cases with stage I BMPLC did not have a negative effect on the 5-year overall survival. Postoperative pathologic diagnosis classified by the most advanced TNM had a good correlation with prognosis in patients with BMPLC.
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Haitang
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yao
authors.affiliation: Department of Pathology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Keke
authors.initials: K
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Haiyong
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Baohui
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. Electronic address: h_zhao28@163.com.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011300:Preoperative Care; D016016:Proportional Hazards Models; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis