Thoracic Surgery Clinic, Wroclaw Medical University, 105 Grabiszynska Street, 53-439, Wroclaw, Poland.
Department of Pathomorphology, Lower Silesian Center for Lung Diseases, 105 Grabiszynska Street, 53-439, Wrocław, Poland.
Adv Exp Med Biol. 2018;1039:9-17. doi: 10.1007/5584_2017_82.
The occurrence of a second lung tumor after surgical removal of lung cancer usually indicates a lung cancer metastasis, but sometimes a new lesion proves to be a new primary lung cancer, i.e., metachronous lung cancer. The goal of the present study was to conduct a clinical evaluation of patients with metachronous lung cancer and lung cancer metastasis, and to compare the early and distant outcomes of surgical treatment in both cancer types. There were 26 age-matched patients with lung cancer metastases and 23 patients with metachronous lung cancers, who underwent a second lung cancer resection. We evaluated the histological type of a resected cancer, the extent of thoracosurgery, the frequency of early postoperative complications, and the probability of 5-year survival after the second operation. The findings were that metachronous lung cancer was adenocarcinoma in 52% of patients, with a different histopathological pattern from that of the primary lung cancer in 74% of patients. In both cancer groups, mechanical resections were the most common surgery type (76% of all cases), with anatomical resections such as segmentectomy, lobectomy, or pneumectomy being much rarer conducted. The incidence of early postoperative complications in metachronous lung cancer and lung cancer metastasis (30% vs. 31%, respectively) and the probability of 5-year survival after resection of either cancer tumor (60.7% vs. 50.9%, respectively) were comparable. In conclusion, patients undergoing primary lung cancer surgery require a long-term follow-up due to the risk of metastatic or metachronous lung cancer. The likelihood of metachronous lung cancer and pulmonary lung cancer metastases, the incidence of postoperative complications, and the probability of 5-year survival after resection of metachronous lung cancer or lung cancer metastasis are similar.
肺癌手术后发生第二肺肿瘤通常提示肺癌转移，但有时新病变证明是新原发性肺癌，即异时性肺癌。本研究的目的是对异时性肺癌和肺癌转移患者进行临床评估，并比较两种癌症类型手术治疗的早期和远处结果。有 26 例年龄匹配的肺癌转移患者和 23 例异时性肺癌患者接受了第二次肺癌切除术。我们评估了切除癌症的组织学类型、胸腔手术的范围、术后早期并发症的频率以及第二次手术后 5 年生存率的概率。结果发现，异时性肺癌 52%的患者为腺癌，74%的患者与原发性肺癌的组织病理学模式不同。在这两个癌症组中，机械切除术是最常见的手术类型（所有病例的 76%），解剖性切除术（如节段切除术、肺叶切除术或肺切除术）则更为少见。异时性肺癌和肺癌转移的早期术后并发症发生率（分别为 30%和 31%）以及两种癌症肿瘤切除后的 5 年生存率（分别为 60.7%和 50.9%）相似。总之，由于存在转移性或异时性肺癌的风险，接受原发性肺癌手术的患者需要长期随访。异时性肺癌和肺转移癌的可能性、术后并发症的发生率以及异时性肺癌或肺癌转移切除后的 5 年生存率相似。
