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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 769-777, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Deschamps, PC Pairolero, VF Trastek and WS Payne
During a 13-year period, multiple primary lung cancers were diagnosed in 80
consecutive patients. Forty-four patients had metachronous cancers. The
initial pulmonary resection was lobectomy in 36 patients, bilobectomy in 3,
pneumonectomy in 1, and wedge excision or segmentectomy in 4. The second
pulmonary resection was lobectomy in 16 patients, bilobectomy in 2,
completion pneumonectomy in 7, and wedge excision or segmentectomy in 19.
There were two 30-day operative deaths (mortality rate, 4.5%). Actuarial 5-
and 10-year survival rates after the first pulmonary resection for stage I
disease were 55.2% and 27.0%, respectively. Five-year and 10-year survival
rates for stage I disease after the second pulmonary resection were 41.0%
and 31.5%, respectively. The remaining 36 patients had synchronous cancers.
The pulmonary resection was lobectomy in 18 patients, bilobectomy in 3,
pneumonectomy in 10, and wedge excision or segmentectomy in 8. There were
two 30-day operative deaths (mortality rate, 5.6%). Actuarial overall 5-
and 10-year survival rates after pulmonary resection were 15.7% and 13.8%,
respectively. We conclude that an aggressive surgical approach is safe and
warranted in most patients with multiple primary lung cancers and that the
presence of synchronous primary cancers is ominous.
ARTICLES
Multiple primary lung cancers. Results of surgical treatment
Department of Surgery, Mayo Clinic, Rochester, Minn. 55905.
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