title: The equivalent efficacy of multiple operations for multiple primary lung cancer and a single operation for single primary lung cancer.
abstract: BACKGROUND
  The incidence of synchronous and metachronous multiple primary lung cancers (MPLCs) has been increasing recently. The new multidisciplinary classification of lung adenocarcinoma and TNM Classification of Lung Cancer (7(th) edition, 2009), have improved the understanding of MPLC. Most researchers recommend that surgical therapy should be actively pursued if the patient's physical condition and lung function permit it and if a complete cure can be achieved. However, few studies have reported the long-term efficacy of surgical treatment for MPLC, which we explored in this study.
  
  
  METHODS
  A total of 1,290 Lung cancer patients from a prospectively maintained database, treated by a single surgeon group between January 2000 and July 2013, at Beijing Cancer Hospital, Peking University, were reviewed. We retrospectively analyzed the clinical data of 31 patients diagnosed with MPLC out of 1290 lung cancer patients, focusing on long-term survival.
  
  
  RESULTS
  MPLC patients accounted for 2.4% (31/1,290) of the patient cohort: 27 had synchronous MPLC (87.1%) and 4 had metachronous MPLC (12.9%). The 1-, 3- and 5-year postoperative survival rates were 100%, 75.8% and 75.8%. On stratification according to TNM stage, the 1-, 3- and 5-year of patients with stage I cancer (20 patients) were 100%, 77.2% and 77.2%, not statistically significant with those for the entire cohort (1,290 patients; 95.4%, 80.5% and 66.2%, P=0.455).
  
  
  CONCLUSIONS
  When the patient's physical condition and tumor-related factors permit it, surgery should be the first choice of treatment for MPLC; it is associated with an equivalent efficacy to that of surgery for single primary lung cancer.
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Dai
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: He-Li
authors.initials: HL
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Wan-Pu
authors.initials: WP
authors.lastname: Yan
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Hong-Chao
authors.initials: HC
authors.lastname: Xiong
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Xiao-Zheng
authors.initials: XZ
authors.lastname: Kang
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Yong-Bo
authors.initials: YB
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Fu
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Meng-Ying
authors.initials: MY
authors.lastname: Fan
authors.affiliation: Department of Thoracic Surgery I, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Ke-Neng
authors.initials: KN
authors.lastname: Chen
keywords: Multiple primary lung cancer (MPLC); surgery; survival