Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Patients undergoing initial lung cancer surgery may develop new, separate lung cancers (synchronous or metachronous).
• Evaluating outcomes of a second surgical procedure for contralateral lung cancer is essential for treatment planning.

Purpose of the Study:

• To assess the outcomes of patients who underwent a second contralateral anatomic surgical resection for primary lung cancer.

Main Methods:

• Retrospective analysis of 55 patients undergoing bilateral anatomic resection for second primary lung cancer.
• Exclusion of nonanatomic resections, benign lesions, and ipsilateral second resections.
• Data collected from a prospective indexed database across two centers between January 2011 and September 2018.

Main Results:

• The study included 55 patients, predominantly for metachronous cancers, with lobectomy being the most common initial procedure.
• The second resection interval averaged 38 months, with a shift towards segmentectomy and increased use of video-assisted thoracic surgery (VATS).
• Ninety-day mortality was 10.9%, with a 3-year survival rate of 77%; prognostic factors included extent of resection and surgical approach.

Conclusions:

• Contralateral anatomic resection for multiple primary lung cancers is a viable option.
• This approach presents a higher early mortality risk but offers acceptable long-term survival.
• Careful patient selection is paramount for successful outcomes in second contralateral lung cancer resections.