Hazards of Recurrence, Second Primary, or Other Tumor at Ten Years After Surgery for Non–Small-Cell Lung Cancer

• Published in: Clinical lung cancer Vol. 21; no. 4; pp. 333 - 340
• Main Authors: Fink-Neuboeck, Nicole, Lindenmann, Joerg, Porubsky, Christian, Fediuk, Melanie, Anegg, Udo, Maier, Alfred, Smolle, Josef, Lamont, Eugenia, Smolle-Juettner, Freyja Maria
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2020
• Subjects: Bronchial carcinoma; Long-term follow-up; Other malignancies; Prognosis; Relapse; Bronchial carcinoma; Long-term follow-up; Relapse; Prognosis; Other malignancies
• ISSN: 1525-7304; 1938-0690
• DOI: 10.1016/j.cllc.2020.02.011

Better treatment options entail the risk of multiple tumors in a patient’s lifetime. We studied the incidence, risk factors, and prognostic impact of second primaries and other malignancies in patients with operated non–small-cell lung cancer (NSCLC). We retrospectively analyzed 342 consecutive patients with curatively resected NSCLC between 2003 and 2007. Among the 342 patients analyzed, 172 (50.3%) developed locoregional and/or distant recurrence; 25 (7.3%) had a second primary lung cancer, 97 (28.3%) had 1 or more malignancies other than NSCLC either in their history (n = 61; 17.8%) or following resection (n = 64; 18.7%). One hundred fifteen patients (33.6%) had a malignancy other than primary NSCLC. Eight patients developed both a second primary lung cancer and another malignancy. Older age and lower N-stage were significantly correlated with the occurrence of an additional tumor, as shown by a logistic regression nomogram. Whereas the risk of recurrence decreases over time, the risk of developing a second tumor, particularly a second primary lung cancer, remains high during up to 10 years of follow-up. One hundred seventy patients (49.7%) died of the primary (n = 158; 46.2%) or second primary (n = 12; 3.5%) NSCLC, 23 (6.7%) died of another malignancy, and 66 (19.3%) died due to unrelated causes (overall 10-year survival, 33.3%). Second primary lung cancer or other malignancy occurs in 33% of patients with NSCLC; 26% of patients are affected within 10 years after resection of lung cancer. With curative treatment of secondary tumors, there is no negative influence on long-term prognosis of NSCLC; therefore, follow-up beyond 5 years is strongly advisable. Long-term survivors of lung cancer develop a predisposition for a second primary tumor. We evaluated 342 patients with curatively resected non–small-cell lung cancer. Second primary lung cancer or other malignancy was detected in 33% of all cases, whereas 26% of patients were affected within 10 years after resection of lung cancer. Therefore, follow-up beyond 5 years is strongly advisable.