Dong-Seok Lee1, Christopher LaChapelle1, Emanuela Taioli2, Andrew Kaufman1, Andrea Wolf1, Daniel Nicastri1, Raja M Flores3. 1. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York. 2. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York. 3. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York. Electronic address: raja.flores@mountsinai.org.
Abstract
BACKGROUND: Patients who have undergone curative surgery for stage I lung cancer require continued surveillance owing to the risk of a second primary lung cancer developing. Early diagnosis allows for prompt intervention. However, as in primary cancers, the role of wedge vs lobar resections remains controversial. METHODS: The Surveillance Epidemiology and End Results database was examined from 2004 to 2012 and all pathologically proven stage I lung cancer patients who underwent cancer-directed surgery were selected. Cases in which a second primary lung cancer developed 6 or more months after diagnosis of the first cancer were analyzed for survival after surgical treatment. RESULTS: Second primary lung cancer was identified in 625 patients, of whom 331 (53%) were diagnosed with stage I disease; 43.8% of patients underwent surgery alone, 30.9% received radiation alone, and 21.0% received neither surgery nor radiation. Of the patients who underwent surgery, 57.7% received wedge resection and 36.5% received a lobectomy. Surgical intervention was a positive predictor of survival-both wedge resection and lobectomy exhibited improved outcomes vs no surgery-but there was no statistically significant difference between the two surgical modalities. CONCLUSIONS: Wedge and lobar resections demonstrate similar survival for second primary lung cancers.
BACKGROUND:Patients who have undergone curative surgery for stage I lung cancer require continued surveillance owing to the risk of a second primary lung cancer developing. Early diagnosis allows for prompt intervention. However, as in primary cancers, the role of wedge vs lobar resections remains controversial. METHODS: The Surveillance Epidemiology and End Results database was examined from 2004 to 2012 and all pathologically proven stage I lung cancerpatients who underwent cancer-directed surgery were selected. Cases in which a second primary lung cancer developed 6 or more months after diagnosis of the first cancer were analyzed for survival after surgical treatment. RESULTS: Second primary lung cancer was identified in 625 patients, of whom 331 (53%) were diagnosed with stage I disease; 43.8% of patients underwent surgery alone, 30.9% received radiation alone, and 21.0% received neither surgery nor radiation. Of the patients who underwent surgery, 57.7% received wedge resection and 36.5% received a lobectomy. Surgical intervention was a positive predictor of survival-both wedge resection and lobectomy exhibited improved outcomes vs no surgery-but there was no statistically significant difference between the two surgical modalities. CONCLUSIONS: Wedge and lobar resections demonstrate similar survival for second primary lung cancers.