Wassmer F A, Racloz Y, Mégevand R
Département de Chirurgie, Hôpital Cantonal Universitaire, Genève 4, Suisse.
Ann Chir. 1991;45(2):163-6.
The first description of multiple primary tumors of the lung was reported by Billroth in 1889. In a series of 448 thoracotomies for lung cancer in the Department of Thoracic Surgery of the Geneva Cantonal University Hospital, 11 were performed in 9 men and 2 women for double metachronous lung tumors. The tumor-free time interval between the operations ranged from 9 months to 15 years, with a mean of 61 months. The tumor was in the contralateral lung in 4 patients and in the ipsilateral one in 7 cases. Pathological examination demonstrated a different histology in 4 patients (36%). Eight of the 11 patients had resectable disease. Twenty-five percent of the patients survived without recurrence for 5 years. Four patients (36%) died within one year of diagnosis of the second tumor; three of these patients did not have a resectable second tumor. The risk of development of a second primary lung carcinoma is low, less than 1-2.1% in some series, 2.7% in our series. The survival is fairly similar to that of primary lung carcinomas in general. Surgery offers the best treatment for these tumors, which is why resection of lung carcinomas should be as limited as possible. Long-term follow-up for more than 5 years and suppression of carcinogenic factors are therefore justified.
1889年，比尔罗特首次报道了肺部多发性原发性肿瘤。在日内瓦州立大学医院胸外科进行的一系列448例肺癌开胸手术中，9名男性和2名女性因双发性异时性肺肿瘤接受了11例手术。两次手术之间的无瘤时间间隔为9个月至15年，平均为61个月。4例患者的肿瘤位于对侧肺，7例位于同侧肺。病理检查显示4例患者（36%）组织学不同。11例患者中有8例疾病可切除。25%的患者存活且5年无复发。4例患者（36%）在诊断出第二个肿瘤后的一年内死亡；其中3例患者的第二个肿瘤不可切除。发生第二个原发性肺癌的风险较低，在一些系列研究中低于1-2.1%，在我们的系列研究中为2.7%。总体而言，其生存率与原发性肺癌相当。手术为这些肿瘤提供了最佳治疗方法，这就是为什么肺癌切除术应尽可能有限。因此，进行超过5年的长期随访和抑制致癌因素是合理的。
