Surgical treatment of metachronous primary lung carcinomas

Eleven patients were operated on for metachronous primary lung carcinomas. Most patients were heavy smokers. The incidence of primary metachronous carcinomas suitable for the operation was 0.45% of primary lung malignancies operated on during the same period. The mean interval between the first and second operations was 47.3 months. Surgical mortality was 0 after the first operation and 18% (2 out of 11 patients) after the second operation. The second primary malignant tumours were more advanced than the first ones. Two patients were alive at the follow-up 9 and 52 months after the second operation. The cause of the death was pulmonary carcinoma in five patients and respiratory and renal failure in one patient and respiratory insufficiency in one patient. Our findings suggest that reoperation for second primary lung malignant tumours should only be performed if the diagnosis is established early enough and if the primary operation was considered to be radical.