2ND PRIMARY LUNG-CANCER

We reviewed our experience with second primary lung cancer (SPLC) at t he Little Rock Veterans Affairs Medical Center from 1966 to 1993. Fift y-four patients were found to have 65 such lesions after 1,572 ''curat ive'' resections for lung cancer (4.1%). Eleven patients had at least a third primary tumor (3 having more). Metachronous SPLCs comprised 60 % (39/65) and synchronous 40% (26/65). The mean interval between first and second tumors was 54.63 +/- 8 (standard error) months (range, 5 t o 218 months), and that between second and third was 26.1 +/- 7.4 (sta ndard error) (range, 5.5 to 51 months). Squamous cell carcinoma compri sed 58.4% (38/65), adenocarcinoma 30.8% (20/65), and small cell carcin oma 10.8% (7/65). Histology of the SPLC was the same as that of the fi rst tumor in 50.7% (33/65). Stage I primary tumors comprised 76% (41/5 4) of index tumors, 61.1% (33/54) of SPLCs, and 72.2% (8/11) of third primary tumors. Second primary lung cancer followed minimal resection in 44% (24/54), lobectomy in 37% (20/54), and pneumonectomy in 13% (7/ 54) of cases. There was no evidence that minimal resection for the fir st primary tumor predisposed to SPLC. After 1983 the majority of SPLCs were diagnosed with computed tomographic scanning. After resection of SPLCs, survival rates at 3 and 5 years were 26% and 18%, metachronous 39% and 23.4%, and synchronous 12.25% and 12.25%.