Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study

Pietro Bertoglio, Luigi Ventura, Vittorio Aprile, Maria Angela Cattoni, Dania Nachira, Filippo Lococo, Maria Rodriguez Perez, Francesco Guerrera, Fabrizio Minervini, Letizia Gnetti, Alessandra Lenzini, Francesca Franzi, Giulia Querzoli, Guido Rindi, Salvatore Bellafiore, Federico Femia, Giuseppe Salvatore Bogina, Diana Bacchin, Peter Kestenholz, Enrico RuffiniMassimiliano Paci, Stefano Margaritora, Andrea Selenito Imperatori, Marco Lucchi, Luca Ampollini, Alberto Claudio Terzi

Research output: Contribution to journalArticle


OBJECTIVES: Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes.METHODS: We retrospectively reviewed data of patients radically operated on for stage I-II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups.RESULTS: We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008).CONCLUSIONS: In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalInteractive Cardiovascular and Thoracic Surgery
Publication statusPublished - 2022


  • Adenocarcinoma subtype
  • Lung adenocarcinoma
  • Lung cancer
  • Multiple cancers
  • Thoracic surgery


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