Comparison of PFT and anatomic resection methods in patients undergoing multiple thoracic surgery for malignancy synchronous, metachronous, metastatic lung tumors

Abstract

Aim: The incidence of synchronous and metachronous lung cancers has been due to early diagnosis and curative resection of the first tumor. Tumors from other organs that metastasize to the lungs or primary lung lesions that develop after complete surgical treatment of other cancers can cause confusion regarding the diagnosis and treatment. We compared the preoperative pulmonary function tests (PFT) and surgical technique used in the first and second surgeries in cases undergoing thoracic surgery when a malignancy was found after the first complete resection of malignancy in the lung or another organ. Material and Method: We retrospectively evaluated cases undergoing multiple thoracic surgery between 2006 and 2012 at the Pamukkale University Faculty of Medicine, Department of Thoracic Surgery, and classified them as synchronous, metachronous and metastatic. The groups were evaluated for age, gender, respiratory function tests, surgical technique used, histopathological diagnosis and stage, postoperative complications and du-ration between surgeries. Results: The mean age was 61.80±8.53 years with a female/male rate of 2/9. There were 1 synchronous, 7 metachronous and 3 metastatic cases. The most common surgical technique for the first surgery was lobectomy with 9 cases and wedge resection for the second surgery with 8 cases. The most common histopathological type for both surgeries was adenomacarcinoma with 8 cases and 6 cases for the first and second surgeries respectively. There was no statistically significant difference between the first and second thoracotomies regarding PFT values (p>0.05), while a significant difference was present for the surgical technique used (p<0.05). Discussion: Anatomic resection should be performed at the first surgery for lung cancer if it is not metastatic while parenchyma-preserving surgery should be performed for metachronous or metastatic tumors seen during follow up, once the diagnostic tests are carried out without delay.