Ishida T, Saitoh G, Maruyama R, Fukuyama Y, Hamatake M, Inoue T, Mitsudomi T, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Int Surg. 1995 Jul-Sep;80(3):227-30.
A second operation was done on 59 patients with lung cancer (7.4% of all those with lung cancer) as a second primary (double primary), during 1974-1991. There were 16 synchronous tumors (interval less than one year) and 43 metachronous tumors (interval over one year). The criteria for diagnosing lung cancer as a second primary from intrapulmonary metastases were any of the following: 1) different histologic type; 2) origin from carcinoma in situ; 3) gross appearance suggestive of primary lung cancer. The initial operation was in the stomach in 14 patients and in the lung in 10. The overall 5-year survival rate in the double primaries was 57.8%, and the prognosis was similar to those in the single primaries of the lung. Nineteen patients died from the second tumor following the second operation, compared with 5 from the initial tumor. The incidence of primary lung cancer increases, and close follow-up after resection for malignant neoplasms detects a new shadow in the chest roentgenogram. It offers a chance of early detection of primary lung cancer and subsequent resection with acceptable results.
1974年至1991年期间，对59例肺癌患者（占所有肺癌患者的7.4%）进行了第二次手术，作为第二原发性肿瘤（双原发性肿瘤）。其中有16例为同时性肿瘤（间隔时间少于一年），43例为异时性肿瘤（间隔时间超过一年）。将肺癌诊断为肺内转移以外的第二原发性肿瘤的标准如下：1）组织学类型不同；2）起源于原位癌；3）大体外观提示原发性肺癌。初次手术部位为胃的有14例，为肺的有10例。双原发性肿瘤患者的总体5年生存率为57.8%，其预后与原发性肺癌患者相似。第二次手术后，有19例患者死于第二原发性肿瘤，而因初次肿瘤死亡的有5例。原发性肺癌的发病率上升，恶性肿瘤切除术后密切随访可在胸部X线片上发现新的阴影。这为早期发现原发性肺癌并随后进行切除提供了机会，且结果可接受。
