[Surgical treatment for recurrent pulmonary carcinoma including same and different cell types]

There are many problems regarding diagnosis of the next lung cancer as local recurrence, metastasis or 2nd primary and there is a limit to only morphologic findings. It may be necessary to examine oncogene abnormalities for example p53 mutation. From the above-mentioned facts, this study distinguished the recurrent resected lung tumors between same (As: n = 19) and different (Ah: n = 8) cell types from the 1st lung cancer. These 2 groups were compared each other and with group B, which was treated to recurrent lung cancer only with chemotherapy and/or radiation, and group C, which was not treated. On 5-year survival after the 1st operation, group As was 78.9%, group Ah was 75.0%, group B was 15.0%, group C was 0%. On 5-year survival after the 2nd operation, group As was 21.1%, group Ah was 42.9%. There were long intervals between the 1st and the 2nd operations (overall mean 56.1+/- 45.6 month, max 190 month), therefore we must follow up on patients undergone resection of lung cancer at the long-term periods. Recent amelioration of chemotherapy and radiotherapy can keep patients with recurrent lung cancer survive by over 5 years. It is important not only to perform an aggressive 2nd operation for recurrent lung cancer but also to estimate post-2nd-operative lung function for selection of operative procedure and to prefer multidisciplinary treatment.