The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers

BackgroundThe incidence of multiple primary lung cancers (MPLCs) has been on the rise over the past decade, yet optimal surgical strategies remain debated. This study compared perioperative outcomes and long-term quality of life (QoL) between simultaneous and staged uniportal video-assisted thoracos...

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Main Authors: Miao Shi, Long-fei Wang, Xue-chi Zhang, Li-wei Tang, Lei Zheng, Wen-tao Hu, Zhi-gang Liang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1639138/full
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author Miao Shi
Long-fei Wang
Xue-chi Zhang
Li-wei Tang
Lei Zheng
Wen-tao Hu
Zhi-gang Liang
author_facet Miao Shi
Long-fei Wang
Xue-chi Zhang
Li-wei Tang
Lei Zheng
Wen-tao Hu
Zhi-gang Liang
author_sort Miao Shi
collection DOAJ
description BackgroundThe incidence of multiple primary lung cancers (MPLCs) has been on the rise over the past decade, yet optimal surgical strategies remain debated. This study compared perioperative outcomes and long-term quality of life (QoL) between simultaneous and staged uniportal video-assisted thoracoscopic surgery (U-VATS) for bilateral early-stage MPLC.MethodsA retrospective cohort analyzed 69 patients undergoing simultaneous (n=28) or staged (n=41) U-VATS between March 2021 and December 2023. A comparative statistical analysis was conducted to assess perioperative efficacy and long-term QoL between simultaneous versus staged U-VATS in patients with bilateral synchronous MPLCs.ResultsThe simultaneous group exhibited smaller tumors (P=0.002) and included more smokers (P=0.019). Compared to staged surgery, simultaneous U-VATS resulted in a shorter hospital stay (8 vs. 14 days, P<0.001), reduced non-steroidal drug use (240 vs. 440 mg, P<0.001), and lower costs (CNY 41218.11 vs. CNY 68041.55, P<0.001), with comparable operative times (P=0.193). Pulmonary infections were less common following simultaneous surgery (3.6% vs. 24.4%, P=0.045). No 30-day mortality occurred. Longitudinal QoL assessment using a standardized 8-item symptom scale (cough, polypnea, pain, fatigue, sweating, insomnia, constipation, throat irritation) identified significant advantages for simultaneous surgery in polypnea (P=0.015) and pain control (P=0.013), whereas remaining symptoms showed comparable trajectories (all P>0.05).ConclusionSimultaneous U-VATS may be a safe, cost-effective option for early-stage MPLC, particularly in patients with smaller tumors. Larger multicenter studies are warranted to validate these findings.
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spelling doaj-art-62b673c263e74f0fbc2f6b77e21f4e472025-08-20T03:02:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16391381639138The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancersMiao Shi0Long-fei Wang1Xue-chi Zhang2Li-wei Tang3Lei Zheng4Wen-tao Hu5Zhi-gang Liang6Department of Thoracic Surgery, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, ChinaDepartment of Thoracic Surgery, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, ChinaNingbo University Schoool of Medicine, Ningbo, Zhejiang, ChinaDepartment of Thoracic Surgery, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, ChinaNingbo University Schoool of Medicine, Ningbo, Zhejiang, ChinaDepartment of Thoracic Surgery, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, ChinaDepartment of Thoracic Surgery, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, ChinaBackgroundThe incidence of multiple primary lung cancers (MPLCs) has been on the rise over the past decade, yet optimal surgical strategies remain debated. This study compared perioperative outcomes and long-term quality of life (QoL) between simultaneous and staged uniportal video-assisted thoracoscopic surgery (U-VATS) for bilateral early-stage MPLC.MethodsA retrospective cohort analyzed 69 patients undergoing simultaneous (n=28) or staged (n=41) U-VATS between March 2021 and December 2023. A comparative statistical analysis was conducted to assess perioperative efficacy and long-term QoL between simultaneous versus staged U-VATS in patients with bilateral synchronous MPLCs.ResultsThe simultaneous group exhibited smaller tumors (P=0.002) and included more smokers (P=0.019). Compared to staged surgery, simultaneous U-VATS resulted in a shorter hospital stay (8 vs. 14 days, P<0.001), reduced non-steroidal drug use (240 vs. 440 mg, P<0.001), and lower costs (CNY 41218.11 vs. CNY 68041.55, P<0.001), with comparable operative times (P=0.193). Pulmonary infections were less common following simultaneous surgery (3.6% vs. 24.4%, P=0.045). No 30-day mortality occurred. Longitudinal QoL assessment using a standardized 8-item symptom scale (cough, polypnea, pain, fatigue, sweating, insomnia, constipation, throat irritation) identified significant advantages for simultaneous surgery in polypnea (P=0.015) and pain control (P=0.013), whereas remaining symptoms showed comparable trajectories (all P>0.05).ConclusionSimultaneous U-VATS may be a safe, cost-effective option for early-stage MPLC, particularly in patients with smaller tumors. Larger multicenter studies are warranted to validate these findings.https://www.frontiersin.org/articles/10.3389/fonc.2025.1639138/fullU-VATSsimultaneous resectionbilateral MPLCsquality of lifeperioperative outcomes
spellingShingle Miao Shi
Long-fei Wang
Xue-chi Zhang
Li-wei Tang
Lei Zheng
Wen-tao Hu
Zhi-gang Liang
The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
Frontiers in Oncology
U-VATS
simultaneous resection
bilateral MPLCs
quality of life
perioperative outcomes
title The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
title_full The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
title_fullStr The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
title_full_unstemmed The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
title_short The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers
title_sort curative effect analysis of simultaneous u vats for bilateral multiple primary early stage lung cancers
topic U-VATS
simultaneous resection
bilateral MPLCs
quality of life
perioperative outcomes
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1639138/full
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