SURGERY OF LOCAL RECURRENCE OF MALIGNANT LUNG-TUMOR

Forty-seven reoperations were performed on 46 patients for local recur rence of carcinoma and other malignant tumors of the lung after surgic al treatment. In two thirds of cases the local recurrence was a conseq uence of various errors in therapeutic tactics and surgical techniques made during the operation for the primary tumor. The malignant lung t umor recurred in periods of 4 weeks to 20 years after the operation, b ut mostly (in 74,5% of patients) in the first 5 years. The authors bel ieve that the criteria of a local recurrence are the same morphologica l structure as of the primary tumor and localization of the second tum or in the stump of the resected bronchus or in the zone of the previou s operation. In 17.0% of cases the recurrent tumor was less differenti ated than the primary tumor, and in 34.0% it metastasized to the regio nal lymph nodes. Pneumonectomy-type removal of the remaining parts of the pulmonary tissue was the operation of choice in local recurrence o f lung carcinoma. Organ preserving operations were performed only in l ocal recurrence of less malignant tumors. Five-year survival after rep eated operations in local recurrence of malignant lung tumors was 42.6 % and depended on the morphological structure of the recurrent tumor.