Surgical outcomes of ipsilateral metachronous second primary lung cancer |
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Authors: | Seijiro Sato Yuki Shimizu Tatsuya Goto Terumoto Koike Takahisa Koizumi Takehiro Watanabe Hirohiko Shinohara Yasushi Yamato Masanori Tsuchida |
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Affiliation: | 1. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;2. Department of Thoracic Surgery, National Hospital Organization Nishi-Niigata Chuo Hospital, Niigata, Japan;3. Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, Niigata, Japan |
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Abstract: | Open in a separate windowOBJECTIVESThe optimal surgical approach for metachronous second primary lung cancer (MSPLC), especially ipsilateral MSPLC, remains unclear. This study aimed to review postoperative complications and examine surgical outcomes based on the extent of resection after surgery for ipsilateral MSPLC.METHODSClinical data from 61 consecutive patients who underwent pulmonary resection for ipsilateral MSPLC according to the Martini–Melamed criteria between January 2005 and December 2017 in 3 institutes were retrospectively reviewed.RESULTSPostoperative complications were identified in 12 patients (19.7%). Regarding the combination of initial and second surgery, intraoperative bleeding was significantly greater in patients with anatomic–anatomic resection than in others (P < 0.001). Operation time was significantly longer in patients with anatomic–anatomic resection than in others (P < 0.001). However, postoperative complications showed no significant differences based on the combination of surgeries. Five-year overall survival rates in patients with anatomic resection and wedge resection after second surgery were 75.8% and 75.8%, respectively (P = 0.738), and 5-year recurrence-free survival rates were 54.2% and 67.6%, respectively (P = 0.368). Cox multivariate analysis identified ever-smoker status (P = 0.029), poor performance status (P = 0.011) and tumour size >20 mm (P = 0.001) as independent predictors of poor overall survival, while ever-smoker status (P = 0.040) and tumour size >20 mm (P = 0.007) were considered independent predictors of poor recurrence-free survival.CONCLUSIONSRegarding postoperative and long-term outcomes for patients with ipsilateral MSPLC, surgical intervention is safe and offers good long-term survival. Wedge resection is an acceptable provided tumours ≤2 cm and ground-glass opacity-predominant as a second surgery for early-stage ipsilateral MSPLC. |
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Keywords: | Ipsilateral metachronous second primary lung cancer Ipsilateral second surgery Wedge resection Anatomic resection Postoperative complications |
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