Ucvet Ahmet, Yazgan Serkan, Samancilar Ozgur, Gursoy Soner, Erbaycu Ahmet Emin, Komurcuoglu Berna
Department of Thoracic Surgery, Health Sciences University, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey.
Department of Thoracic Surgery, Medicana International Izmir Hospital, Izmir, Turkey.
Kardiochir Torakochirurgia Pol. 2021 Dec;18(4):221-226. doi: 10.5114/kitp.2021.112188. Epub 2022 Jan 9.
We reviewed our surgical preferences and the prognosis for recurrent and second primary tumors in patients who underwent surgical treatment for non-small cell lung carcinoma (NSCLC).
We report our experience with patients undergoing iterative pulmonary resection for lung cancer.
Among patients who underwent anatomical resection for primary NSCLC, those who underwent a second surgical resection between 2010 and 2020 due to recurrent or second primary tumor were included in the study. Operative mortality, survival, and prognostic factors were investigated.
In total, 77 cases were included: 31 (40.3%) underwent the second resection for the recurrent disease and 46 (59.7%) underwent the second resection for the second primary tumor. Postoperative mortality occurred in 8 (10.4%) patients. All patients with postoperative mortality were in the group that underwent thoracotomy in both surgical procedures. The 5-year survival rate was 46.5%. The 5-year survival of those operated on for recurrent or second primary tumor was 32.8% and 51.1%, respectively ( = 0.81). The 5-year survival rate was 68.8% in patients under the age of 60 years, while it was 27.5% in patients aged 60 years and above ( = 0.004). The 5-year survival was 21.8% in patients with an interval of 36 months or less between two operations and 72.2% in those with a longer interval ( = 0.028).
Our study shows that survival results similar to or better than primary NSCLC surgery can be obtained with lower mortality if more limited resections are performed via video-assisted thoracic surgery, especially in young patients. In addition, the prognosis is better in patients with an interval of more than 36 months between two operations.
我们回顾了接受非小细胞肺癌（NSCLC）手术治疗患者的手术偏好以及复发性和第二原发性肿瘤的预后情况。
我们报告对接受肺癌反复肺切除术患者的治疗经验。
在接受原发性NSCLC解剖性切除术的患者中，纳入2010年至2020年间因复发性或第二原发性肿瘤接受二次手术切除的患者。对手术死亡率、生存率和预后因素进行了研究。
共纳入77例病例：31例（40.3%）因复发性疾病接受二次切除，46例（59.7%）因第二原发性肿瘤接受二次切除。8例（10.4%）患者发生术后死亡。所有术后死亡患者均在两次手术均行开胸手术的组中。5年生存率为46.5%。因复发性或第二原发性肿瘤接受手术的患者5年生存率分别为32.8%和51.1%（P = 0.81）。60岁以下患者5年生存率为68.8%，而60岁及以上患者为27.5%（P = 0.004）。两次手术间隔36个月或更短的患者5年生存率为21.8%，间隔较长的患者为72.2%（P = 0.028）。
我们的研究表明，如果通过电视辅助胸腔镜手术进行更有限的切除，尤其是在年轻患者中，可以获得与原发性NSCLC手术相似或更好的生存结果，且死亡率更低。此外，两次手术间隔超过36个月的患者预后更好。
