Eastern Cardiothoracic Surgical Society

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Segmentectomies in the Treatment of Synchronous and Metachronous Lung Cancers
Alison Conybeare, Shiva Bikmalla, Christopher Satur.
University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom.

Objective
This study assed the number of patients undergoing surgically resectable lung malignancies for the presence of synchronous and metachronous lung malignancies (SaMLC) and assed the impact of surgical resection of these tumours on the overall survival rate. Other than case studies and diagnostic studies, there is little on SaMLC in the literature, other than Zhang et al (2016), who reviewed the prognostic indicators for synchronous and non-small cell lung cancers. They only looked at radical surgery, which limits the amount of resection available (only 5 lobes in total, compaired with 19 segments). We wanted to see if the use of more limited, but anatomical resections were feasible.
Method
This was a retrospective study looking at all patients undergoing resections for lung malignancies Jan 2010 Dec 2015. Electronic letters and operation notes were reviewed, along with the national database (Somerset) input and multidisciplinary team notes.
Results
28 out of 360 patients undergoing surgery for lung malignancy had a synchronous/metachronous cancer. This was treated surgically in 18 patients, of which 14 were still alive after 5 years. The others were either not suitable for further surgery, declined or had tumours not suitable e.g. small cell carcinomas.
Conclusion
The treatment of SaMLC by segmentectomy produces excellent survival rates, comparable with more radical surgery (lobectomies). However it must be acknowledged that the numbers of patients within this study having surgery for their synchronous and metachronous lung malignancies is limited.


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