Kyobu geka. The Japanese journal of thoracic surgery
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From 1975 to July 1994, twenty patients underwent second or third pulmonary resections for 7 recurrent lung cancers and 14 second primary lung cancers. The initial surgical procedures were lobectomy in 18, pneumonectomy in 1 and bilateral segmentectomy in 1. The procedures at the second operation were completion pneumonectomy in 4, ipsilateral wedge resection in 3, contralateral lobectomy in 1, contralateral segmentectomy in 4, contralateral wedge resection in 7 and resection of left main bronchus in 1. ⋯ Five-year survival rate following second operation in 20 patients was 32.3%, and it was 28.6% for patients with recurrent lung cancers, and 31.2% for multiple primary lung cancers. In conclusion, an aggressive surgical approach for reappearing lung tumor should be performed. At the reoperation, wedge resection for recurrent lung cancers, completion pneumonectomy for ipsilateral primary lung cancers and segmentectomy for contralateral primary lung cancers should be chosen for the standard surgical procedure.
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Twenty-two patients underwent surgical therapy for local recurrence and distant metastasis of lung cancer. Twenty patients were resected the tumor and 2 patients received the operation to improve their quality of life. Seven patients were resected lung metastasis, which were 5 adenocarcinomas and 2 squamous cell carcinomas. ⋯ There were no long-term survivors in 5 patients with bone or soft tissue metastasis. Since the differentiation of lung metastasis from the second primary tumor is impossible, the single lung metastasis should be resected. Resection of single brain metastasis provides better prognosis.