Surgical Treatment and Prognosis of Synchronous Double Primary Lung Cancer: a Report of 31 Cases

BACKGROUND OBJECTIVE: The idea of double primary lung cancer (DPLC) has been generally accepted. Recently, an increasing incidence of synchronous DPLC has been reported, while the diagnostic standard and treatment strategies remain to be improved. This study was to investigate effective surgical treatment, and prognosis of synchronous DPLC. METHODS: From Jan. 1983 to Apr. 2004, 31 patients with synchronous DPLC were operated in our department. Clinical data, such as surgical pattern, postoperative complication, and survival status, of all these patients were reviewed retrospectively. RESULTS: The 31 patients with synchronous DPLC accounted for 0.67% of all 4 649 patients operated for primary lung cancer in our department during the same period. Both tumors of synchronous DPLC were resected with lobectomy or pneumonectomy in 12 patients, while among the other 19 patients, at least 1 tumor was treated with partial pulmonary resection. The postoperative morbidity was 29% (9/31), including 1 case of respiratory insufficiency, 3 cases of atelectasis, 2 cases of atrial fibrillation, 1 case of haemoptysis, 1 case of pleural effusion, and 1 case of wound fat necrosis. No death occurred during operation or within 30 days postoperatively. The postoperative 1-, 3-, and 5-year survival rates were 52%, 29%, and 20%, respectively. CONCLUSIONS: The incidence of synchronous DPLC is low. Aggressive and reasonable surgical approach can achieve satisfactory outcomes in patients with synchronous DPLC. The postoperative morbidity is low. Some patients might achieve long-term survival.