Synchronous, Metachronous or Metastases?

Celalettin İbrahim  Kocatürk

doi:10.5152/EurJTher.2018.1010

Authors

Celalettin İbrahim Kocatürk Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey

DOI:

https://doi.org/10.5152/EurJTher.2018.1010

Keywords:

Multiple primary lung cancer, non-small cell lung cancer, metachronous lung cancers, satellits tumors

Abstract

Multiple primer lung cancer (MPAK) satellite tumors (accessory tumor of the same type with the same tumor in the same lobe) synchronous tumors (at the time of diagnosis, or at the same site within 3 months or with other tumors in the opposite lung) and metachronous tumors (a newly developed tumor in a patient with a definitively treated tumor). Satellite tumors are synchronous tumors also. It may be difficult to understand whether MPAC is primer tumors originating from different areas of the lung, or whether they are metastases from each other. If the histopathological types of the tumors are different from each other, it can be said that they are generally MPAK. However, if histopathological types are the same, histopathological, molecular, genetic and clinical data are needed. It is useful to demonstrate histopathologically that the detailed analysis of tumors (subtype, dominant type, especially in adenocarcinomas) and carcioma insitu background. Genetic and molecular tests are still a matter of debate. It is both very expensive and can be performed in a small number of centers, and not at the expected activity. Because the cancer cells are very complex and constantly undergoing mutation and change. The clinical criteria, especially the Martini-Melamed criteria have been used for a long time. It is still valid. If the histopathological types are different for metachronous tumors, there is no problem, but if they are the same, the second tumor is defined according to the development time. However, it may be more accurate to evaluate these patients independently from time to time. The best survival data is obtained with surgery even if it is second cancer or local recurrence or metachronous cancer Therefore, if patients with synchronous or metachronous cancer are considered to have no distant metastasis or mediastinal involvement, surgical treatment should be the priority.

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