Surgical Treatment for Metachronous Second Primary Lung Cancer after Radical Resection of Primary Lung Cancer

Purpose: We retrospectively reviewed our experience of surgical resection for second primary lung cancer (SPLC) in our institute. And to clarify whether periodic follow-up after resection of first primary lung cancer (FPLC) is associated with earlier detection of SPLC. Methods: From January 2003 to March 2011, a total of 386 patients underwent surgical resection for primary lung cancer in our institute. Of these patients, 21 (5.4%) with SPLC were observed during follow-up after surgery. Radiation therapy was selected instead of surgical resection in 7 patients to preserve respiratory function. The other 14 patients are reviewed in this paper. Results: Histological types were different between FPLC and SPLC in only one patient (FPLC: adenosquamous carcinoma, SPLC: squamous cell carcinoma). The average SPLC tumor size (18 +/- 8 mm) was smaller (P = 0.07) than the average FPLC tumor size (26 +/- 14 mm). Recurrence was not observed in these patients. The follow-up period after resection of SPLC was 31 +/- 30 (5-94) months. During follow-up, 2 patients died of de novo malignancies, and the other 12 patients were alive without recurrence. Conclusion: Systematic and periodic long-term follow-up after FPLC probably resulted in earlier detection of SPLC and yielded this good prognosis.