Abstract：
The initial surgery for lung cancer with interstitial lung disease (ILD) is often followed by passive treatment due to the surgery-induced deterioration in respiratory function, and only a few studies have summarized the findings associated with a second surgery for lung cancer patients with ILD.
Of the 3932 lung cancer patients who underwent surgery at our hospital from August 2008 to July 2019, 404 (10%) patients (1) underwent preoperative computed tomography for imaging of interstitial pneumonia and (2) underwent initial surgery. We analyzed 45 cases (11%) suspected of showing metachronous lung cancer during the postoperative course.
Thirty-four patients (76%) underwent a second surgery. The group that underwent a second surgery showed a significantly better prognosis than the group that did not (p = 0.0009). The surgical procedure was wide-wedge resection/segmentectomy/lobectomy and above in 15/7/12 cases, respectively. Postoperative complications were observed in nine cases (26%) (prolonged pulmonary fistula in five cases, ILD acute exacerbation in two cases, and wound dissection in two cases). Mortality within 30 days occurred in one case (ILD acute exacerbation at postoperative day 15). Twelve patients (35%) experienced recurrence. In the wide-wedge resection group, 2/15 (13%) patients showed stump recurrence. The 1-, 2-, 3-, and 5-year survival rates after surgery for secondary lung cancer were 80.4, 72.5, 68.2, and 39.4%, respectively.
Surgery can be considered an effective treatment method for secondary lung cancer with ILD if the cases are carefully selected.
Of the 3932 lung cancer patients who underwent surgery at our hospital from August 2008 to July 2019, 404 (10%) patients (1) underwent preoperative computed tomography for imaging of interstitial pneumonia and (2) underwent initial surgery. We analyzed 45 cases (11%) suspected of showing metachronous lung cancer during the postoperative course.
Thirty-four patients (76%) underwent a second surgery. The group that underwent a second surgery showed a significantly better prognosis than the group that did not (p = 0.0009). The surgical procedure was wide-wedge resection/segmentectomy/lobectomy and above in 15/7/12 cases, respectively. Postoperative complications were observed in nine cases (26%) (prolonged pulmonary fistula in five cases, ILD acute exacerbation in two cases, and wound dissection in two cases). Mortality within 30 days occurred in one case (ILD acute exacerbation at postoperative day 15). Twelve patients (35%) experienced recurrence. In the wide-wedge resection group, 2/15 (13%) patients showed stump recurrence. The 1-, 2-, 3-, and 5-year survival rates after surgery for secondary lung cancer were 80.4, 72.5, 68.2, and 39.4%, respectively.
Surgery can be considered an effective treatment method for secondary lung cancer with ILD if the cases are carefully selected.
摘要：
肺癌合并间质性肺病（ILD）的初始手术通常是由于手术引起的呼吸功能恶化而被动治疗。只有少数研究总结了与ILD肺癌患者第二次手术相关的发现。
2008年8月至2019年7月在我院接受手术治疗的3932例肺癌患者中，有404例（10%）患者（1例）接受了术前CT检查以检查间质性肺炎，（2例）接受了初次手术。我们分析了在术后过程中怀疑有异时性肺癌的45例（11％）。
34例患者（76%）接受了第二次手术。接受第二次手术的组的预后明显优于未接受手术的组（p=0.0009）。15/7/12例，手术方式为宽楔形切除/肺段切除/肺叶切除及以上。分别。术后并发症9例(26%)(延长肺瘘5例,ILD急性加重2例，和两种情况下的伤口夹层)。一例发生30天内死亡（术后第15天ILD急性加重）。12例患者（35%）复发。在宽楔形切除组中,2/15（13%）患者出现残端复发。1-,2-,3-,继发性肺癌术后5年生存率分别为80.4、72.5、68.2和39.4%，分别。
如果仔细选择病例，手术可以被认为是继发性ILD肺癌的有效治疗方法。
2008年8月至2019年7月在我院接受手术治疗的3932例肺癌患者中，有404例（10%）患者（1例）接受了术前CT检查以检查间质性肺炎，（2例）接受了初次手术。我们分析了在术后过程中怀疑有异时性肺癌的45例（11％）。
34例患者（76%）接受了第二次手术。接受第二次手术的组的预后明显优于未接受手术的组（p=0.0009）。15/7/12例，手术方式为宽楔形切除/肺段切除/肺叶切除及以上。分别。术后并发症9例(26%)(延长肺瘘5例,ILD急性加重2例，和两种情况下的伤口夹层)。一例发生30天内死亡（术后第15天ILD急性加重）。12例患者（35%）复发。在宽楔形切除组中,2/15（13%）患者出现残端复发。1-,2-,3-,继发性肺癌术后5年生存率分别为80.4、72.5、68.2和39.4%，分别。
如果仔细选择病例，手术可以被认为是继发性ILD肺癌的有效治疗方法。
