Diagnosis, Treatment and Prognosis for Multiple Cancers : Primary in the Lung and Other sites or a Second Primary Lung Cancer

Abstract

Between August 1974 and June 1978, of the 1603 lung cancer patients seen in our hospital 67 had double cancers (lung cancer and primary neoplasm of an other organ), 8 had a second primary lung cancer and one had multiple primary lung cancers plus cancer of the larynx.Of the double cancers, the majority were lung cancer plus gastric cancer in males and uterine cancer in females. In 33 of the 67 patients the lung cancer was resectable. The 32 surgicallytreated patients with stage I-III lung cancer had an overall 5-year survival rate of 62%. The survival rate of the non-resectable group was very poor : 13% at 2 years with median survival time of 7 months. Thus we consider that lung resection is indicated in patients whose tumors are felt to be resectable.Of 8 patients with a second primary lung cancer, 7 had the same histology in the original and the second primary lung cancer. Seven patients were heavy smokers, suggesting that excessive cigarette smoking plays a role in the development of a second primary lung cancer. Surgical treatment for a second lesion is generally difficult; 3 patients underwent lung resection. One patient had 4 separate primary lung cancers and cancer of the larynx. He received pneumonectomy for the first tumor in the right lung, and then multi-modality treatments for each new lesion. He has been well for 3 years with residual tumors.