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Ann Thorac Surg 2001;71:309-313
© 2001 The Society of Thoracic Surgeons
a Department of Pulmonary Diseases, Sint Antonius Hospital, Nieuwegein, The Netherlands
b Department of Pathology, Sint Antonius Hospital, Nieuwegein, The Netherlands
c Department of Thoracic Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
d Department of Thoracic Surgery, University Medical Center, Utrecht, The Netherlands
Accepted for publication May 2, 2000.
Address reprint requests to Dr van Rens, MD, Sint Antonius Hospital, Department of Pulmonary Diseases, PO Box 2500, 3430 EM Nieuwegein, The Netherlands
e-mail: antolong{at}knmg.nl
Background. In a number of patients with treated primary non–small cell lung cancer (NSCLC) a second primary tumor will be diagnosed. Our experience with surgery in these patients was analyzed and possible prognostic parameters were defined.
Methods. Patients with metachronous NSCLC (n = 127) who underwent resection from 1970 through 1997 were analyzed. All tumors were classified postsurgically. Median interval between the tumors was 3.7 years. Actuarial survival time was estimated and risk factors influencing survival were evaluated.
Results. Overall 5-year survival after the first resection was 70% and after the second resection was 26%. Patients with stage IA of the second primary tumor did have a significantly better survival (p < 0.005) as compared with patients with higher staged second primaries. Stage of second primary tumor and age were significant predictors of survival, whereas stage of first tumor, interval between resections, histology, and type of resection were not.
Conclusions. Survival of patients with metachronous NSCLC and resection of both tumors is high, but poorer than after resection of the first tumor. Irrespective of the interval, patients with stage IA second primary tumor may benefit more from pulmonary resection.
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