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@#With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.
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<p><b>BACKGROUND</b>At the time of being diagnosed as non-small cell lung cancer (NSCLC), 65%-70% of the patients are at the advanced stage (stage III, IV). It is believed that the multi-modality therapy has a better efficacy than mono-therapy. The aim of this study is to evaluate the efficacy of multi-modality therapy based on surgery in advanced NSCLC.</p><p><b>METHODS</b>The clinicopathological data were retrospectively reviewed from 51 stage IIIB-IV NSCLC patients, who underwent surgery and multiple modality therapy during 1995 to 2003 in the department of Thoracic Surgery of PUMC Hospital. The survival of patients was analyzed.</p><p><b>RESULTS</b>The overall 1- and 3-year survival rate was 86.35%±5.21% and 52.96%±8.83%, respectively. The median survival time was 37.0 months.</p><p><b>CONCLUSIONS</b>The multi-modality therapy based on surgery could improve the survival of operable patients with advanced NSCLC.</p>
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Objective To assess the value of lobectomy by video-assisted mini-thoracotomy(VAMT) for the treatment of peripheral pulmonary carcinoma.Methods From January 2004 to December 2007,56 cases of peripheral pulmonary carcinoma underwent VAMT lobectomy under general anaesthesia in our hospital.Of the patients,5 had the tumor in the upper lobe of the right lung,2 in the middle lobe of the right lung,19 in the superior lobe of the right lung,8 in the upper lobe of the left lung,and 22 in the superior lobe of the left lung.All the tumors were no more than 5 cm in diameter.All the cases were intubated with double-lumen tubes and then one-lung ventilation was performed.With the patients being placed in a lateral position,a mini-incision(6.0-8.0 cm in length) was made at the fourth or fifth intercostal space.And another 1.5-cm incision was made at the sixth intercostal space along the midaxillary line for introducing the video-thoracoscope.The resected pulmonary lobe was removed though the mini-incision.Afterwards,enlarged lymph nodes were dissected as routine.Results During the operation,no incision was prolonged in the cases.A mean of 14 lymph nodes were removed(ranged from 9 to 31).The mean operation time was(145?35) min(range,120 to 220 min),and the intraoperative hemorrhage was 100 to 450 ml [(210?48) ml].The patients were discharged from hospital in 5 to 11 days(mean,7 days).Seven of the patients developed complications including thoracic effusion in 5 and atelectasis in 2.The patients were followed up for 1 year,3 of them died during the period(1 year survival rate:94.6%).Conclusion VAMT lobectomy is feasible and safe for peripheral lung cancer.