The benefits of surgical treatment for metachronous lung cancer are not well described. The aim of this study was to evaluate the validity and efficacy of surgical treatment for metachronous lung cancers.
From January 1995 to December 2004, a total of 37 patients underwent a second resection for a metachronous lung cancer. We reviewed the charts of these patients and analyzed type of resection, operative morbidity, mortality, and survival by stage. All tumors were classified postsurgically. Survival was calculated by the Kaplan-Meier method and the data were evaluated with the log rank’s test.
The mean interval between the first and second resection was 39.7±31.0 months. Ninety-five percent of the patients presented stage I cancers, 2.7% with stage II, and 2.7% with stage III cancers. Lobectomy was performed in 16.2% of the patients, segmentectomy in 27.0%, and wedge resection in 56.8% for the metachronous cancers. Operative mortality for the second resection was 5.4% (2 out of 37 patients). These two patients died of acute respiratory distress syndrome during the early postoperative period. The mean follow-up after the second resection was 42.1 months. The 1-, 2-, 5-year actuarial survival for the entire group after the second resection was 86.5, 83.4, and 79.5% respectively.
Operations for metachronous lung cancers provided the improved prognosis of these patients. Surgical treatment should be considered as a safe and effective strategy for resectable metachronous lung cancers in patients with adequate physiologic pulmonary reserve.
We found surgical resection of metachronous lung cancers could be performed in selected patients with meaningful long-term survival. This finding suggests that there might be benefit to systematic postoperative surveillance of patients after resection with the goal of detecting metachronous tumors at the earliest possible stage.
Makoto Takahama, None.