The role of surgical treatment in second primary lung cancer

Abstract

BACKGROUND : This study was designed to assess the treatment of patients in whom a second primary lung cancer developed after the resection of primary lung cancer.

METHODS : Between January 1990 and December 2008, 1852 patients underwent complete resection for primary lung cancer in our institution. Of these individuals, patients who had been identified as having a second primary lung cancer by December 2009 were selected for this study using the criteria proposed by Martini and Melamed.

RESULTS : Of 1852 patients, a second primary lung cancer developed in 40 (2.2%) during the follow-up period. The overall 5-year and 10-year survival rates after the resection of the first tumor were 78.3% and 39.9%, respectively. The overall 5-year survival rate from the time of detection of the second primary lung cancer was 47.8%, and the 5-year survival rate of the patients who underwent resection of the second tumor was 77.0%. The patients who underwent sublobar resection had comparable overall survival and disease-free survival compared with the patients who underwent anatomic resection. Additionally, the patients who underwent sublobar resection had a better operative outcome.

CONCLUSIONS : Surgical resection is feasible and effective in the management of second primary lung cancer, and sublobar resection may be adequate. Long-term surveillance of more than 5 years is essential for early detection to increase the chance of resection of a second primary lung cancer.