Purpose: To evaluate the outcomes of patients
surgically treated for their second primary lung cancer.
Method: In a computerized surgical registry of > 800
consecutive patients treated for primary pulmonary carcinoma since
1980, 37 patients presented with a second lung cancer. These patients
were analyzed regarding their original treatment, preoperative
evaluation, operative procedures, and long-term follow-up.
Results: Three fifths of the patients were female, and 57%
were ≥ 65 years old at the time of their second operation. One
patient originally had two synchronous tumors; another patient had
three metachronous neoplasms. The interval between surgeries ranged
from 5 to 239 months. In 31 patients, treatment for their original
tumor was surgical resection alone. Lobectomy was the most common
operation for the original tumor, and 78% were stage I. When the
second tumor was diagnosed, 25 patients (68%) were asymptomatic. Eight
patients (22%) were current smokers, and 29 patients (78%) were
former smokers. The most common operation for the second tumor was a
lobectomy. Surgical mortality was 5.4%. Nineteen patients (51%)
survived 2 years, and 9 patients (24%) survived ≥ 5 years. Eleven
patients (30%) were still alive at last follow-up, 3 to 198 months
postoperatively, and only 13 patients (34%) had died of their
Conclusion: Surgical treatment of second
primary pulmonary neoplasms can be performed in selected patients with
acceptable long-term survival.