Screen-detected multiple primary lung cancers in the ITALUNG trial

• DOI: 10.21037/jtd.2018.01.95
• Publication Date: 2018-02-14T11:56:17Z
• Authors: Mario Mascalchi; Camilla E. Comin; Elena Bertelli; Lapo Sali; Cristina Maddau; Stefania Zuccherelli; Giulia Picozzi; Laura Carrozzi; Michela Grazzini; Gabriella Fontanini; Luca Voltolini; Alessandra Vella; Francesca Castigl...; Francesca Carozzi; Eugenio Paci; Maurizio Zompatori; Andrea Lopes Pegna; Fabio Falaschi
• Keywords: 03 medical and health sciences; Adenocarcinoma; Low-dose CT screening; Lung cancer; Multiple primary lung cancer; Pulmonary and Respiratory Medicine; 0302 clinical medicine; Adenocarcinoma; Low-dose CT screening; Lung cancer; Multiple primary lung cancer; 3. Good health

Occurrence of multiple primary lung cancers (MPLC) in individuals undergoing low-dose computed tomography (LDCT) screening has not been thoroughly addressed. We investigated MPLC in subjects recruited in the ITALUNG randomized clinical trial. Cases of cytologically/histologically proven MPLC detected at screening LDCT or follow-up CT were selected and pathologically re-evaluated according to the WHO 2015 classification. Overall 16 MPLC were diagnosed at screening LDCT (n=14, all present at baseline) or follow-up CT (n=2) in six subjects (4 in one subject, 3 in two and 2 in three subjects), representing 0.43% of the 1,406 screenees and 15.8% of the 38 subjects with at least one screen-detected primary lung cancer. MPLC included 9 adenocarcinomas in three subjects and a combination of 7 different tumour histotypes in three subjects. MPLC, mostly adenocarcinomas, are not uncommon in smokers and ex-smokers with at least one LDCT screen detected primary lung cancer.