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Dai Shimizu
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P06 - Early Stage/Localized Disease - Multiple Primary Lung Cancer (ID 115)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P06.02 - Prognostic Factors and Strategies for Metachronous Second Primary Lung Cancer (ID 1983)
00:00 - 00:00 | Presenting Author(s): Dai Shimizu
- Abstract
Introduction
Due to the development of imaging modalities and well-established sublobar lung resection techniques, diagnosis and treatment strategies for metachronous second primary lung cancer (MSPLC) has drastically changed. However, appropriate follow-up duration and extent of resection for MSPLC has not yet been established. The aim of this study is to clarify the prognostic factors of patients with surgically resected metachronous lung cancers.
Methods
A retrospective chart review was performed on 37 MSPLC patients who had surgical resections of both first and second tumors at our institution from January 2003 to December 2017. We defined MSPLC according to the criteria proposed by Martini and Melamed.
Results
The median follow-up period for the first and second operations were 9.81 years and 3.55 years, respectively. In 18 patients (48.6%), the interval between the first and second lung cancer resections were longer than 5 years. The median tumor size of the second lung cancer was significantly smaller compared with the first lung cancer (15mm vs 25mm, respectively; P=0.00313). For the first lung cancer resection, 25 patients (67.6%) had lobectomy and 12 patients (32.4%) had sublobar resection. In contrast, 6 patients (16.2%) had lobectomy and 31 patients (83.8%) had sublobar resection for the second lung cancer resection. The 5-year survival rate after the second surgery was 79.4%. Among 8 patients (21.6%) of postoperative mortality, 5 patients died of primary lung cancer. Seven patients (18.9%) experienced recurrence during the follow-up period. The disease-specific survival (DSS) did not differ significantly among lobectomy, segmentectomy and partial resection (P=0.611). Patients with an interval 5 or more years between the two primary lung cancers demonstrated significantly better DSS (P=0.0474) and disease-free survival (P=0.0497) compared with those with less than 5 years interval.
Conclusion
In the present study, MSPLCs were resected at an earlier stage compared with the first lung cancer. This finding suggests that our follow-up strategy after the first cancer resection was appropriate. Sublobar resections for MSPLC yielded a favorable postoperative survival outcome, probably due to the early detection of MSPLC. We also demonstrated that almost half of the patients with MSPLC experience second lung cancer more than 5 years after the first lung cancer resection and that longer intervals are related to a better prognosis. Careful follow-up for more than 5 years after surgical treatment may lead to early detection of MSPLC and better survival outcomes.
