Association of the Extent of Resection with Survival in Multiple Primary Lung Cancer: A Systematic Review

Nicola Tamburini, Cristina Bombardini, Marco Chiappetta, Pio Maniscalco, Giorgia Valpiani, Alfredo Cesario, Roberto Cirocchi, Gabriele Anania, Antonio Stefanelli, Giorgio Cavallesco, Stefano Margaritora, Filippo Lococo

Research output: Contribution to journalArticle


Background The incidence of synchronous multiple primary lung cancer (SMPLC) has progressively increased, due to recent advances in imaging. To date, no guidelines defining recommendations for patients' selection and no standard treatment of cases with SMPLC have been defined. The primary aim of this systematic review was to assess survival among patients treated with lobectomy or sublobar resection MPLC. Methods Comprehensive literature search of Medline, the Cochrane Library, reference lists, and ongoing studies was performed according to a prospectively registered design (PROSPERO: CRD42019115487). All studies published between 1998 and December 2020 that examined treatments with lobectomy compared to sublobar resection were included. Two double-blind investigators independently selected articles. Primary outcomes were to assess the 5-year overall survival (OS) rate among patients treated with lobectomy or sublobar resection and the impact of lymph node status on 5-year OS and 5-year disease-free survival in patients with MPLC. Results The search yielded 424 articles; 4 observational studies met the inclusion criteria and collectively evaluated 298 patients with a mean age ranging from 61.5 to 67 years. A total of 112 patients were treated for bilateral synchronous tumors and 186 patients for unilateral multiple synchronous tumors. All included studies showed that the type of resection, lobectomy or limited resection, had no significant impact on survival. Conclusion Limited resection is a valuable treatment option for MPLC. However, the clinical level of evidence of the studies found is low and randomized studies are needed to clarify the extent of resection in MPLC.
Original languageEnglish
Pages (from-to)145-158
Number of pages14
JournalThoracic and Cardiovascular Surgeon
Publication statusPublished - 2023


  • lung cancer treatment (surgery medical)
  • thoracoscopy
  • VATS
  • diagnosis
  • complications
  • lung cancer
  • surgery


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