title: Survival after resection of metachronous non-small cell lung cancer in 127 patients.
abstract: BACKGROUND
  In a number of patients with treated primary non-small cell lung cancer (NSCLC) a second primary tumor will be diagnosed. Our experience with surgery in these patients was analyzed and possible prognostic parameters were defined.
  
  
  METHODS
  Patients with metachronous NSCLC (n = 127) who underwent resection from 1970 through 1997 were analyzed. All tumors were classified postsurgically. Median interval between the tumors was 3.7 years. Actuarial survival time was estimated and risk factors influencing survival were evaluated.
  
  
  RESULTS
  Overall 5-year survival after the first resection was 70% and after the second resection was 26%. Patients with stage IA of the second primary tumor did have a significantly better survival (p < 0.005) as compared with patients with higher staged second primaries. Stage of second primary tumor and age were significant predictors of survival, whereas stage of first tumor, interval between resections, histology, and type of resection were not.
  
  
  CONCLUSIONS
  Survival of patients with metachronous NSCLC and resection of both tumors is high, but poorer than after resection of the first tumor. Irrespective of the interval, patients with stage IA second primary tumor may benefit more from pulmonary resection.
authors.affiliation: Department of Pulmonary Diseases, Sint Antonius Hospital, Nieuwegein, The Netherlands. antolong@knmg.nl
authors.forename: M T
authors.initials: MT
authors.lastname: van Rens
authors.forename: P
authors.initials: P
authors.lastname: Zanen
authors.forename: A B
authors.initials: AB
authors.lastname: de la Rivière
authors.forename: H R
authors.initials: HR
authors.lastname: Elbers
authors.forename: H A
authors.initials: HA
authors.lastname: van Swieten
authors.forename: J M
authors.initials: JM
authors.lastname: van den Bosch
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000401:mortality* / Q000601:surgery*; D011013:Pneumonectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis