van Rens M T, Zanen P, de la Rivière A B, Elbers H R, van Swieten H A, van den Bosch J M
Department of Pulmonary Diseases, Sint Antonius Hospital, Nieuwegein, The Netherlands.
Ann Thorac Surg. 2001 Jan;71(1):309-13. doi: 10.1016/s0003-4975(00)02423-1.
In a number of patients with treated primary non-small cell lung cancer (NSCLC) a second primary tumor will be diagnosed. Our experience with surgery in these patients was analyzed and possible prognostic parameters were defined.
Patients with metachronous NSCLC (n = 127) who underwent resection from 1970 through 1997 were analyzed. All tumors were classified postsurgically. Median interval between the tumors was 3.7 years. Actuarial survival time was estimated and risk factors influencing survival were evaluated.
Overall 5-year survival after the first resection was 70% and after the second resection was 26%. Patients with stage IA of the second primary tumor did have a significantly better survival (p < 0.005) as compared with patients with higher staged second primaries. Stage of second primary tumor and age were significant predictors of survival, whereas stage of first tumor, interval between resections, histology, and type of resection were not.
Survival of patients with metachronous NSCLC and resection of both tumors is high, but poorer than after resection of the first tumor. Irrespective of the interval, patients with stage IA second primary tumor may benefit more from pulmonary resection.
在一些接受过治疗的原发性非小细胞肺癌（NSCLC）患者中，会诊断出第二种原发性肿瘤。我们分析了这些患者的手术经验，并确定了可能的预后参数。
分析了1970年至1997年间接受手术切除的异时性NSCLC患者（n = 127）。所有肿瘤均在术后进行分类。肿瘤之间的中位间隔时间为3.7年。估计了精算生存时间，并评估了影响生存的危险因素。
首次切除后的总体5年生存率为70%，第二次切除后的为26%。与更高分期的第二种原发性肿瘤患者相比，第二种原发性肿瘤为IA期的患者生存率明显更高（p < 0.005）。第二种原发性肿瘤的分期和年龄是生存的重要预测因素，而第一种肿瘤的分期、两次切除之间的间隔、组织学类型和切除方式则不是。
异时性NSCLC患者切除两种肿瘤后的生存率较高，但低于首次肿瘤切除后的生存率。无论间隔时间如何，第二种原发性肿瘤为IA期的患者可能从肺切除中获益更多。
