Yuzhao Wang, MD, Jonathan C. Yeung, MD, PhD, Waël C

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Metachronous or synchronous primary lung cancer in the era of computed tomography surveillance Yuzhao Wang, MD, Jonathan C. Yeung, MD, PhD, Waël C. Hanna, MBA, MD, Frances Allison, MSc, Narinder S. Paul, MD, Thomas K. Waddell, MD, PhD, Marcelo Cypel, MD, Marc E. de Perrot, MD, Kazuhiro Yasufuku, MD, PhD, Shaf Keshavjee, MSc, MD, Andrew F. Pierre, MSc, MD, Gail E. Darling, MD, FRCSC The Journal of Thoracic and Cardiovascular Surgery Volume 157, Issue 3, Pages 1196-1202 (March 2019) DOI: 10.1016/j.jtcvs.2018.09.052 Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Development of size and change of proportion of ground-glass opacity from first identification to diagnosis for SPLC and MPLC. The blue curve represents SPLC development, starting at the time of IPLC diagnosis and ending at the median time to SPLC diagnosis (33.6 months). The red curve represents MPLC development, starting at the median time to MPLC first identification (38.4 months) and ending at the median time to its diagnosis (another 7.2 months). The graph depicts the more rapid increase in cancer size of MPLC versus SPLC. It also shows a sharp decrease in ground-glass opacity proportion from first identification to diagnosis in SPLC, but not in MPLC. GGO, Ground-glass opacity; IPLC, initial primary lung cancer; MPLC, metachronous primary lung cancer; SPLC, synchronous primary lung cancer. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 1196-1202DOI: (10.1016/j.jtcvs.2018.09.052) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Comparison of IPLC survival between SPLC and MPLC cohorts. The number of patients at risk is listed under the figure. The colored bands represent the 95% CIs. No significant differences between the SPLC and MPLC cohorts were observed in overall survival from IPLC. MPLC, Metachronous primary lung cancer; SPLC, synchronous primary lung cancer. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 1196-1202DOI: (10.1016/j.jtcvs.2018.09.052) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of second lung cancer survival between SPLC and MPLC cohorts. The number of patients at risk is listed under the figure. The colored bands represent the 95% CIs. No significant differences between the SPLC and MPLC cohorts were observed in overall survival from second lung cancer. MPLC, Metachronous primary lung cancer; SPLC, synchronous primary lung cancer. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 1196-1202DOI: (10.1016/j.jtcvs.2018.09.052) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

SPLC had a more rapid increase in cancer size than MPLC from identification to diagnosis. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 1196-1202DOI: (10.1016/j.jtcvs.2018.09.052) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions