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Eur J Cardiothorac Surg 2007;32:653-658. doi:10.1016/j.ejcts.2007.06.024
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Primary lung cancer and extrapulmonary malignancy

Hans-Stefan Hofmanna,*, Heinz Neefa, Peter Schmidtb

a Department of Cardio-Thoracic Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Street 40, 06096 Halle, Germany
b Cancer Center Halle of the Martin Luther University Halle-Wittenberg, Ernst-Grube-Street 40, 06096 Halle, Germany

Received 7 March 2007; received in revised form 6 June 2007; accepted 11 June 2007.

* Corresponding author. Tel.: +49 345 557 2719; fax: +49 345 557 2782. (Email: stefan.hofmann{at}medizin.uni-halle.de).

Objective: The incidence of second primary malignancies seems to be increasing. The aim of this study was to investigate the incidence, treatment and outcome for patients with second primary lung cancer (SPLC). Methods: Between January 1996 and December 2005, 163 patients with SPLC, occurring after an extrapulmonary malignancy, were recruited by the Tumor Center of Halle (Saale), which represents a region of nearly 1.0 million inhabitants in Germany. The SPLCs were treated under curative aim (n = 59), with palliative intend (n = 76) or best supportive care (n = 28). Results: The incidence of SPLC was 1.6 per 100,000 inhabitants. The localization of the first tumor differed depending on the sex of the patients. The actuarial 5-year survival rate of all patients was 12.7% (median survival time 11.4 months). Univariate analysis revealed treatment strategy as a prognostic factor (p = 0.0001). Patients with SPLC having undergone curative treatment turned out to have the best prognosis (median survival: 31.0 months). The Cox proportional hazards model demonstrated that only TNM-staging system was a multivariate and significant independent prognostic predictor for overall survival. The method of surgery, standard lung resection (e.g. lobectomy) versus limited resection had no considerable influence on overall survival (p = 0.22), respectively recurrence-free survival (p = 0.55). Conclusions: In cases of operability, standard resection must be the method of choice, because of its best survival rates. The results support the demand of an exact and short-term oncological care system to detect early stages of SPLC for patients operated upon for tumors at different sites.

Key Words: Lung cancer • Extrapulmonary malignancy • Surgery • Survival






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.