Surgical treatment of synchronous multiple lung adenocarcinomas; experiment of 171 cases

Background: It is unclear how to treat synchronous multiple lung adenocarcinoma (SMLA) cases, which are increasing with the development of high-resolution computed tomography (HRCT). Methods: Retrospective review of 171 cases of SMLA who underwent curative intent surgery between 2010 and 2018. Lung volume-preserving surgery, segmentectomy or wedge resection, is preferred for ground glass opacity nodules (GGN) within 2.0 cm. Clinical observation is allowed for pure GGN within 1.0 cm. Results: The 5-year recurrence-free survival rate after surgery was 95.2%, and the overall survival rate was 93%. Prognosis was correlated with the degree of progression of the dominant tumor. Tumor number, surgical procedure and remnant tumor after surgery were not correlated with prognosis. Conclusions: The prognosis of SMLA was relatively good, and was dependent on the stage and malignant potential of the dominant tumor. Limited resection and clinical observation for GGN are acceptable.