Second Primary Lung Cancers Demonstrate Better Survival with Surgery than Radiation

Objective Patients who have had curative surgery for lung cancer are at the highest risk of developing a new lung cancer. Individual studies are usually underpowered to describe the clinical characteristics and outcomes in second primary lung cancer. The goal of this study is to determine which therapy is best associated with survival in patients who develop a new primary lung cancer. Methods All pathologically proven stage I lung cancer cases that received cancer-directed surgery included in the Surveillance Epidemiology and End Results (SEER) database between 2004 and 2010 were selected. Cases that received radiation therapy were excluded. Cases which developed a second primary lung cancer 6 or more months after the diagnosis of the first cancer were analyzed. The original data set consisted of 9,564 stage I lung cancer cases treated with surgery; 520 of them developed a second primary and completed data were available for 494 of them. Results Stage I disease was diagnosed in 272 patients with second primary lung cancers (58.5%); 45.8% of these underwent cancer surgery alone, 31.6% received radiation alone. Surgery was performed more frequently in early stages and younger patients. Surgical patients had statistically significant longer survival than patients treated with radiation (log-rank p