Lung Cancer as a Second Primary Malignancy: Increasing Prevalence and Its Influence on Survival

The purpose of this study was to review the experience with lung cancer as a second primary malignancy (LCSPM) and to determine whether a history of previous malignancy was an independent prognostic factor in resected non small cell lung cancer (NSCLC). We included 414 patients undergoing pulmonary resection with a curative intention between January 1986 and January 2007. The criteria for classifying a lesion as a lung cancer as a second primary malignancy (LCSPM) were a different histological type or a tumor of identical histological type occurring more than 3 years after treatment of the primary tumor, or separated from the initial primary tumor by more than 2 cm of clinically normal epithelium. Thirty-four patients (8.2%) had a history of a previous malignancy. LCSPM were more frequent during the last decade (11.4% vs. 3.91%, P = .0009). Breast, uroepithelial, and lung cancer were the most prevalent initial primary tumors. In 64.7% of patients the time interval between the last malignancy and the current lung cancer was 2 years or shorter. Patients with NSCLC and a previous malignancy did not have a significantly different survival rate than patients with the current NSCLC as the first malignancy (5-year survival 65.3% vs. 58.6%, log-rank P = .416). The effectiveness of the surgical resection and the subsequent survival of these patients appear to be well demonstrated, and operative mortality and complications are no higher than for other lung cancer patients.