| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:1001-1008
© 2003 The Society of Thoracic Surgeons
a department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
b department of Clinical Cancer Prevention, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
c department of Thoracic/Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
d department of Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
* Address reprint requests to Dr Rice, Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 445, Houston, TX 77030, USA.
e-mail: drice{at}mdanderson.org
Presented at the Thirty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2003.
BACKGROUND: The incidence of second primary lung cancers (SPLC) after resection of nonsmall cell lung cancer (NSCLC) is estimated to be 1% to 4% per patient year. The overall effect of SPLC on survival after resection of stage I NSCLC is unknown. Here we report the incidence, management, and outcome of SPLC in a large prospective cohort of patients who underwent careful follow-up.
METHODS: National Cancer Institute Intergroup Trial NCI #I91-0001 examined the effectiveness of isotretinoin A for chemoprevention of second primary tumors, the primary endpoint in that trial. Prospective data from patients randomly assigned to the placebo arm were analyzed.
RESULTS: Five hundred sixty-nine patients underwent complete resection of pathologic stage I NSCLC. The median follow-up was 5.9 years. Second primary tumors developed in 88 (15%) patients. Of these, 49 (56%) were SPLC (incidence = 1.99/100 patient-years), with a median interval from initial surgery of 4.2 years. Second primary lung cancer never developed in patients who had never smoked (n = 44, p = 0.046; never versus ever smokers). Current smokers had a higher incidence of SPLC than former smokers (hazard ratio = 1.91, p = 0.03). Age, sex, stage, histology, tumor location and initial surgery had no effect on SPLC development. Despite semiannual follow-up with chest radiographs, 12 (24%) patients had metastatic disease at the time of diagnosis of SPLC. Surgical resection was performed in 31 (63%) SPLC patients. Median survival was 4.1 years in those who underwent surgery and 1.4 years in those who did not (p = 0.003). Overall SPLC-related mortality in the original cohort was 3.7%.
CONCLUSIONS: Patients who undergo surgery for SPLC can achieve prolonged survival. Despite close follow-up however many patients with SPLC present with advanced disease. That indicates a need for continued lifelong postoperative surveillance.
This article has been cited by other articles:
|
|
 |
|
  B. E. Lee, J. L. Port, B. M. Stiles, J. Saunders, S. Paul, P. C. Lee, and N. Altorki TNM Stage Is the Most Important Determinant of Survival in Metachronous Lung Cancer. Ann. Thorac. Surg., October 1, 2009; 88(4): 1100 - 1105. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Grodzki, J. Alchimowicz, A. Kozak, B. Kubisa, J. Pierog, J. Wojcik, M. Bielewicz, and D. Witkowska Additional pulmonary resections after pneumonectomy: actual long-term survival and functional results Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 493 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Furak, I. Trojan, T. Szoke, A. Wolfard, E. Nagy, I. Nemeth, L. Tiszlavicz, and G. Lazar Lung cancer as a second primary malignant tumor: prognostic values after surgical resection Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 50 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Rubins, M. Unger, and G. L. Colice Follow-up and Surveillance of the Lung Cancer Patient Following Curative Intent Therapy: ACCP Evidence-Based Clinical Practice Guideline (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 355S - 367S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Hishida, K. Nagai, J. Yoshida, M. Nishimura, G.-i. Ishii, M. Iwasaki, and Y. Nishiwaki Is surgical resection indicated for a solitary non-small cell lung cancer recurrence? J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 838 - 842. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Sugimura and P. Yang Long-term Survivorship in Lung Cancer: A Review. Chest, April 1, 2006; 129(4): 1088 - 1097. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Belinsky, K. C. Liechty, F. D. Gentry, H. J. Wolf, J. Rogers, K. Vu, J. Haney, T. C. Kennedy, F. R. Hirsch, Y. Miller, et al. Promoter hypermethylation of multiple genes in sputum precedes lung cancer incidence in a high-risk cohort. Cancer Res., March 15, 2006; 66(6): 3338 - 3344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Kent, P. Korn, J. L. Port, P. C. Lee, N. K. Altorki, and R. J. Korst Cost Effectiveness of Chest Computed Tomography After Lung Cancer Resection: A Decision Analysis Model Ann. Thorac. Surg., October 1, 2005; 80(4): 1215 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Gritz, C. Dresler, and L. Sarna Smoking, The Missing Drug Interaction in Clinical Trials: Ignoring the Obvious Cancer Epidemiol. Biomarkers Prev., October 1, 2005; 14(10): 2287 - 2293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Belinsky, D. M. Klinge, J. D. Dekker, M. W. Smith, T. J. Bocklage, F. D. Gilliland, R. E. Crowell, D. D. Karp, C. A. Stidley, and M. A. Picchi Gene Promoter Methylation in Plasma and Sputum Increases with Lung Cancer Risk Clin. Cancer Res., September 15, 2005; 11(18): 6505 - 6511. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Collaborative Ocular Melanoma Study Group Second Primary Cancers After Enrollment in the COMS Trials for Treatment of Choroidal Melanoma: COMS Report No. 25 Arch Ophthalmol, May 1, 2005; 123(5): 601 - 604. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Korst, H. T. Gold, M. S. Kent, J. L. Port, P. C. Lee, and N. K. Altorki Surveillance computed tomography after complete resection for non-small cell lung cancer: Results and costs J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 652 - 660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Kim, H. Lee, H. Kim, Y. M. Shim, J. Han, J. Park, and D.-H. Kim Promoter Methylation of Retinoic Acid Receptor Beta 2 and the Development of Second Primary Lung Cancers in Non-Small-Cell Lung Cancer J. Clin. Oncol., September 1, 2004; 22(17): 3443 - 3450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Scott Metachronous lung cancer: the role of improved postoperative surveillance J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 633 - 635. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
