Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1710068
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

Alex Fourdrain
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
,
Patrick Bagan
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
2  Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, Argenteuil, France
,
Olivier Georges
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
,
Sophie Lafitte
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
,
Florence De Dominicis
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
,
Jonathan Meynier
3  Department of Biostatistics, Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
,
Pascal Berna
1  Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
› Author Affiliations
Further Information

Publication History

28 January 2020

09 March 2020

Publication Date:
22 May 2020 (online)

Abstract

Background Patients treated surgically for lung cancer may present synchronous or metachronous lung cancers. The aim of this study was to evaluate outcomes after a second contralateral anatomic surgical resection for lung cancer.

Methods We performed a retrospective two-center study, based on a prospective indexed database. Included patients were treated surgically by bilateral anatomic surgical resection for a second primary lung cancer. We excluded nonanatomic resections, benign lesions, and ipsilateral second surgical resections.

Results Between January 2011 and September 2018, 55 patients underwent contralateral anatomic surgical resections for lung cancer, mostly for metachronous cancers. The first surgical resection was a lobectomy in most cases (45 lobectomies: 81.8%, 9 segmentectomies: 16.4%, and 1 bilobectomy: 1.8%), and a video-assisted thoracic surgery (VATS) procedure was used in 23 cases (41.8%). The mean interval between the operations was 38 months, and lobectomy was less frequent for the second surgical resection (35 lobectomies: 63.6% and 20 segmentectomies: 36.4%), with VATS procedures performed in 41 cases (74.5%). Ninety-day mortality was 10.9% (n = 6), and 3-year survival was 77%. Risk factor analysis identified the number of resected segments during the second intervention or the total number of resected segments, extent of resection (lobectomy vs. segmentectomy), surgical approach (thoracotomy vs. VATS), tumor stage, and nodal involvement as potential prognostic factors for long-term survival.

Conclusion A second contralateral anatomic surgical resection for multiple primary lung cancer is possible, with a higher early mortality rate, but acceptable long-term survival, and should be indicated for carefully selected patients.

Note

This article was submitted and accepted for the Poster Session at the 27th European Conference on General Thoracic Surgery in Dublin, Ireland, June 9–12, 2019.