Iterative surgical resections in non-small cell lung cancer

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Non-small cell lung carcinoma (NSCLC) recurrence and second primary tumors necessitate further treatment.
• Surgical intervention is a key modality for managing these complex cases.
• Evaluating outcomes of re-operation is crucial for refining treatment strategies.

Purpose of the Study:

• To report the surgical experience with iterative pulmonary resections for lung cancer.
• To investigate operative mortality, survival rates, and prognostic factors in patients undergoing repeat lung cancer surgery.

Main Methods:

• Retrospective review of patients undergoing anatomical resection for primary NSCLC.
• Inclusion of patients with a second surgical resection for recurrence or a second primary tumor between 2010-2020.
• Analysis of operative mortality, survival data, and prognostic indicators.

Main Results:

• 77 patients underwent re-operation: 31 for recurrence, 46 for second primary tumors.
• Overall 5-year survival was 46.5%; 32.8% for recurrence, 51.1% for second primary.
• Younger patients (<60 years) and longer intervals (>36 months) between surgeries showed significantly better 5-year survival.

Conclusions:

• Iterative pulmonary resection can achieve survival rates similar to or better than primary NSCLC surgery.
• Video-assisted thoracic surgery and longer intervals between operations are associated with improved outcomes and reduced mortality.
• Younger patient age is a significant positive prognostic factor for survival after repeat lung cancer surgery.