Abstract
Objective. The reported incidence of second primary lung cancer has increased steadily, because the proportion of early-stage lung cancer has increased and long-term surgical results for early-stage lung cancer have improved. In this report, we reviewed surgical results for second primary lung cancer. Methods. The data from the lung cancer registry on patients with multiple primary lung cancer from January 1996 to December 2003 were reviewed. Results. During the 8-year period, a total of 523 patients underwent pulmonary resection for primary lung cancer. Nineteen patients developed a second primary lung cancer. Of those 19 patients, 16 patients underwent pulmonary resection for second primary lung cancer. There were 10 men and 6 women patients. The average age at the second operation was 75. The initial pulmonary resection was lobectomy in 14 patients and segmentectomy in 2. The second pulmonary resection was lobectomy in 4 patients, segmentectomy in 4 and wedge resection in 8. The second primary lung cancer was preoperative stage IA in 11 patients and stage IB in 5. The second primary cancer was postoperative stage IA in 13 patients, stage IB in 1, and stage IIB in 2. There were no postoperative complications or perioperative deaths among the 16 patients. The overall actuarial 5-year survival for second primary lung cancers was 56.8%, while the actuarial 5-year survival for second primary lung cancers treated with limited resection was 71.1%. Conclusion. We conclude that an aggressive surgical approach is effective and is linked with good outcome for patients with a second primary lung cancer if the tumor is detected within stage I, which has the possibility of cure by performing limited resection. Moreover, careful follow-up at regular intervals should be continued after the first resection.
