Clinical diagnosis and treatment of multiple pulmonary nodules.
10.3760/cma.j.cn112152-20220606-00390
- Author:
Hua ZHONG
1
;
Feng YAO
2
;
Qun Hui CHEN
3
;
Jin Dong GUO
4
;
Lin Cheng ZHANG
1
;
Yao ZHANG
1
;
Bao Hui HAN
1
Author Information
1. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
2. Department of Thoracic Surgery Department, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
3. Department of Radiotherapy, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
4. Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
- Publication Type:Journal Article
- Keywords:
Ablation therapy;
Ground glass opacity;
Lung neoplasms;
Multiple primary lung cancer;
Multiple pulmonary nodules;
Surgery
- MeSH:
Humans;
Multiple Pulmonary Nodules/surgery*;
Lung Neoplasms/surgery*;
Adenocarcinoma/surgery*;
Lung/pathology*;
Tomography, X-Ray Computed
- From:
Chinese Journal of Oncology
2023;45(6):455-463
- CountryChina
- Language:Chinese
-
Abstract:
CT screening has markedly reduced the lung cancer mortality in high-risk population and increased the detection of early-stage pulmonary neoplasms, including multiple pulmonary nodules, especially those with a ground-glass appearance on CT. Multiple primary lung cancer (MPLC) constitutes a specific subtype of lung cancer with indolent biological behaviors, which is predominantly early-stage adenocarcinoma. Although MPLC progresses slowly with rare lymphatic metastasis, existence of synchronous lesions and distributed location of these nodules still pose difficulty for the management of such patients. One single operation is usually insufficient to eradicate all neoplastic lesions, whereas repeated surgical procedures bring about another dilemma: whether clinical benefits of surgical treatment outweigh loss of pulmonary function following multiple operations. Therefore, despite the anxiety for treatment among MPLC patients, whether and how to treat the patient should be assessed meticulously. Currently there is a heated discussion upon the timing of clinical intervention, operation mode and the application of local therapy in MPLC. Based on clinical experience of our multiple disciplinary team, we have summarized and commented on the evaluation, surgical treatment, non-surgical local treatment, targeted therapy and immunotherapy of MPLC in this article to provide further insight into this field.
