{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:09:44Z","timestamp":1755216584014,"version":"3.43.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort analyzed 69 patients undergoing simultaneous (n=28) or staged (n=41) U-VATS between March 2021 and December 2023.\u00a0A 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The simultaneous group exhibited smaller tumors (<jats:italic>P<\/jats:italic>=0.002) and included more smokers (<jats:italic>P<\/jats:italic>=0.019). Compared to staged surgery, simultaneous U-VATS resulted in a shorter hospital stay (8 vs. 14 days, <jats:italic>P<\/jats:italic>&amp;lt;0.001), reduced non-steroidal drug use (240 vs. 440 mg, <jats:italic>P<\/jats:italic>&amp;lt;0.001), and lower costs (CNY 41218.11 vs. CNY 68041.55, <jats:italic>P<\/jats:italic>&amp;lt;0.001), with comparable operative times (<jats:italic>P<\/jats:italic>=0.193). Pulmonary infections were less common following simultaneous surgery (3.6% vs. 24.4%, <jats:italic>P<\/jats:italic>=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 (<jats:italic>P<\/jats:italic>=0.015) and pain control (<jats:italic>P<\/jats:italic>=0.013), whereas remaining symptoms showed comparable trajectories (all <jats:italic>P<\/jats:italic>&amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Simultaneous 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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1639138","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T15:13:49Z","timestamp":1754320429000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers"],"prefix":"10.3389","volume":"15","author":[{"given":"Miao","family":"Shi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long-fei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-chi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-wei","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-tao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-gang","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1016\/j.jtcvs.2019.11.006","article-title":"The learning curve on uniportal video-assisted thoracic surgery: An analysis of proficiency","volume":"159","author":"Vieira","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa372","article-title":"Uniportal versus multiportal video-assisted thoracoscopic surgery does not compromise the outcome of segmentectomy","volume":"59","author":"Xie","year":"2021","journal-title":"Eur J cardio-thoracic surgery: Off J Eur Assoc Cardio-thoracic Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2021.07.013","article-title":"UniPortal thoracoscopic pneumonectomy does not compromise perioperative and long-term survival in patients with NSCLC: A retrospective, multicenter, and propensity score matching study","volume":"159","author":"Gao","year":"2021","journal-title":"Lung Cancer (Amsterdam Netherlands)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac303","article-title":"VATS versus open thoracotomy for lung cancer resection: is the game still running","volume":"62","author":"Mercier","year":"2022","journal-title":"Eur J cardio-thoracic surgery: Off J Eur Assoc Cardio-thoracic Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1163338","article-title":"Enhanced recovery of postoperative nursing for single-port thoracoscopic surgery in lung cancer patients","volume":"13","author":"Hu","year":"2023","journal-title":"Front Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00798-3","article-title":"The global burden of lung cancer: current status and future trends. 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