55P - Proposed new simple criteria of clinical multiple primary lung cancers

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Imaging, Diagnosis and Staging
Lung and other Thoracic Tumours
Presenter Takeshi Matsunaga
Citation Annals of Oncology (2015) 26 (suppl_1): 15-16. 10.1093/annonc/mdv046
Authors T. Matsunaga, K. Suzuki, K. Takamochi, S. Oh
  • General Thoracic Surgery, Juntendo University School of Medicine, 113-8431 - Tokyo/JP



Martini and Melamed proposed the criteria for diagnosis of multiple primary lung cancer (MPLC) based on pathological features. Because of the easy applicability of these criteria, they have entered standard use by clinicians and pathologists ever since the original publication in 1975. But, recently in practice, we need criteria based not on pathological status, but clinical information to decide the appropriate treatment strategy for MPLC.


A retrospective study was conducted on 588 consecutive patients with resected lung cancer of clinical stage IA between January 2009 and October 2012. All patients underwent preoperative thin-section CT and authors reviewed radiological findings for all cohorts. We defined lung cancer with additional tumor nodules (LC with ATNs) as primary lung cancer having other tumors which were detected on thin-section CT. Among them, all main tumors and all ATNs were divided into pure solid tumor (PST) and non-pure solid tumor (non-PST) according to presence of ground glass opacity (GGO) component based on findings of thin-section CT, which meant PST had no GGO component. We hypothesized that LC with ATNs having at least one non-PST was multiple primary lung cancer (MPLC) group and that of all tumors consisted PST was pulmonary metastasis (PM) group. We compared two groups and investigated prognosis.


LC with ATNs were observed in 103 (17.5%) of 588 patients. MPLC group was observed in 90.3% (93/103) and PM group in 9.7% (10/103). The differences in 2- and 5-year disease-free survival between the MPLC group and PM groups were statistically significant (92.3%/85.8% vs. 65.6%/32.8%, p-value = 0.0008).


We think that the MPLC group was clinical multiple primary lung cancer based on prognosis and a suitable candidate for local treatment such as surgery. We defined clinical MPLC as follows: 1) At least one of them having GGO component, 2) Clinical N0.


All authors have declared no conflicts of interest.