The long-term outcomes of metachronous tumors for non-small cell lung cancer

Background

We aimed to identify prognostic factors for mortality and survival in patients operated on for metachronous primary lung cancer (MPLC).

Materials and methods

The data of 67 non-small cell lung cancer patients with MPLC, diagnosed and operated upon between January 2000 and December 2015, were retrospectively analyzed.

Results

Of the 67 included patients, 63 (94%) were male and 4 (6%) were female. The overall survival rate after second surgery was 53.6% at 5 years and 34.1% at 10 years. The mean survival time was 64 months (95% confidence interval: 35–92 months). Adjuvant treatment improved survival (p ​= ​0.039). Although the survival of grade N0 and N1 patients did not differ, four grade N2 patients exhibited poor survival (p ​= ​0.02). Cox's regression analysis revealed that grade N2 disease decreased survival 5.3- fold, the absence of adjuvant treatment decreased survival 2 fold and pT4 grade decreased survival 3.4 fold.

Conclusions

New lung tumors may be detected during follow-up of lung cancer patients who have been definitively treated. In such cases, if extrapulmonary metastases and N2 lymphatic involvement are absent, there is no recurrence in the surgical margins of the first operation, and there is only one new tumor, we suggest that surgical treatment should be initially chosen for patients with adequate cardiopulmonary reserves regardless of the time of appearance of the second tumor, whether or not the histopathological type is the same as that of the first tumor.