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- Original Article -

A Clinical Study on Multiple Primary Cancers in Cases of Resected Lung Cancer

Ryoichi Kondo¹, Takao Sakaizawa¹, Kyoko Kato¹, Yoshiaki Tominaga¹, Takashi Eguchi¹, Nobutaka Kobayashi¹, Akira Hyogotani¹, Takayuki Shiina¹, Kazuo Yoshida¹, Jun Amano^1
1Department of Surgery, Shinshu University School of Medicine, Japan

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Objective. We examined the influence of multiple primary cancers and their clinical features on outcome in cases of excised lung cancer. Methods. We targeted 101 out of 731 cases (13.8%) which presented multiple primary cancers in lung cancer operations performed in our hospital between January 1996 and December 2005. We then conducted comparative analysis with the clinical features and outcome of the 619 cases which did not present multiple primary cancers. Results. Many of the multiple primary cancers were present in the stomach, large intestine, breast, uterus, head and neck. The cases of lung cancer with multiple primary cancers did not show a significant difference compared to the cases of lung cancer alone in terms of age, sex, histological type, degree of differentiation, or pathological stage. There were many cases of lung squamous cell carcinoma in the patients with existing esophagus, head and neck cancer. Furthermore, there was a high percentage of lung adenocarcinoma in patients with existing breast, uterus, thyroid, or prostate cancer. The 5-year-survival rate after resection of lung cancer in patients with multiple primary cancers was 59.4%, which was significantly lower than the 71.3% 5-year-survival rate of patients with only lung cancer. The 5-year-survival rates after resection of lung cancer in cases of synchronous and metachronous multiple primary cancers were 57.5% and 65.6%, respectively. The cause of death of patients with lung cancer and multiple primary cancers was lung cancer in 12 cases (42.9%) and cancers of other organs in 6 cases (21.4%). Conclusion. The presence of multiple primary cancers, particularly synchronous cancers, is an adverse prognostic factor in cases of resected lung cancer. Whole body screening including examination of the digestive tract should be performed before and after lung resection.
key words: Lung cancer, Prognosis, Multiple primary cancers

Received: October 1, 2007
Accepted: November 27, 2007

JJLC 48 (1): 33-38, 2008