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Surgical outcomes of second primary lung cancer after the extrapulmonary malignancy

  • Original Article – Clinical Oncology
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Abstract

Objective

To study the surgical outcomes of patients with a second primary lung cancer after the extrapulmonary malignancy.

Materials and methods

Patients who underwent surgical resection for lung cancers between January 2005 and December 2014 were reviewed. Clinical data, imaging characteristics of tumors, surgical approaches, and outcomes were analyzed with a mean follow-up of 97 months.

Results

Of 1075 patients, 166 (15.4%) had a second primary lung cancer after extrapulmonary malignancy. There were no differences in overall 5-year survival rates (81.8% for the group of lung cancer vs. 72.9% for the second primary lung cancer group, p = 0.069) and 5-year disease-free survival (70.1% for the lung cancer group vs. 70.3% for the second primary lung cancer group, p = 0.863) between the two groups. Gender, performance status, tumor size, and maximum standard uptake value (SUVmax) were significantly different between the two groups. After propensity-score matching analysis, patients in the group with lung cancers had better 5-year overall survival (88.1% vs. 72.1% for the group with second primary lung cancers, p = 0.016) and 5-year disease-free survival (80.6% vs. 70.3% for the group with second primary lung cancers; p = 0.054). In the second primary lung cancer group, the patients with preceding breast or thyroid cancers had better prognoses than did those with other extrapulmonary malignancy.

Conclusions

Second primary lung cancers following extrapulmonary malignancies were not uncommon. Surgical resection is considered for early stage secondary primary lung cancer after meticulous work up and result in fair outcome.

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Acknowledgements

This research was supported by the Cancer Registry Group, Tri-Service General Hospital. We thank Miss Chia-Ling Yu, who made a significant contribution to analyzing the patients’ survival data.

Funding

The work was supported by the Tri-Service General Hospital (TSGH-C108-112, TSGH-C04-109-031).

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Authors and Affiliations

  1. Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Kai-Hsiung Ko

  2. Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Hsu-Kai Huang, Yi-I Chen, Hung Chang & Tsai-Wang Huang

  3. Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Wu-Chuan Tsai

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  1. Kai-Hsiung Ko
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  2. Hsu-Kai Huang
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  3. Yi-I Chen
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  4. Hung Chang
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  5. Wu-Chuan Tsai
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Correspondence to Tsai-Wang Huang.

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Ko, KH., Huang, HK., Chen, YI. et al. Surgical outcomes of second primary lung cancer after the extrapulmonary malignancy. J Cancer Res Clin Oncol 146, 3323–3332 (2020). https://doi.org/10.1007/s00432-020-03310-x

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  • DOI: https://doi.org/10.1007/s00432-020-03310-x

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