Purpose: To evaluate the outcomes of patients surgically treated for their
second primary lung cancer.
Method: In a computerized surgical registry of > 800 consecutive patients t
reated for primary pulmonary carcinoma since 1980, 37 patients presented wi
th a second lung cancer. These patients were analyzed regarding their origi
nal treatment, preoperative evaluation, operative procedures, and long-tem
follow-up.
Results: Three fifths of the patients were female, and 57% mere greater tha
n or equal to 65 years old at the time of their second operation. One patie
nt originally had two synchronous tumors; another patient had three metachr
onous neoplasms. The interval between surgeries ranged from 5 to 239 months
. In 31 patients, treatment for their original tumor was surgical resection
alone. Lobectomy was the most common operation for the original tumor, and
78% were stage I. When the second tumor was diagnosed, 25 patients (68%) w
ere asymptomatic. Eight patients (22%) were current smokers, and 29 patient
s (78%) were former smokers. The most common operation for the second tumor
was a lobectomy. Surgical mortality was 5.4%. Nineteen patients (51%) surv
ived 2 years, and 9 patients (24%) survived greater than or equal to 5 year
s. Eleven patients (30%) were still alive at last follow-up, 3 to 198 month
s postoperatively, and only 13 patients (34%) had died of their cancer.
Conclusion: Surgical treatment of second primary pulmonary neoplasms can be
performed in selected patients with acceptable long-term survival.