Mortality and recurrence following surgically treated primary lung malignancy

Abstract

Primary lung malignancy comprised 10.3% of all new cancers detected in Malta in 2020. Our study examines patient outcomes and mortality rates following surgically resected primary lung malignancy.

We retrospectively analysed the electronic records of 126 patients who underwent surgical resection of their primary lung malignancy between 2016 and 2020.

Our study included 126 patients with an average age of 66.4 years and 64.3% were male (n=81). 71 .4% of patients underwent lobectomy (n=90). The median time from date of histological diagnosis to date of resection was 51 days. Adenocarcinoma was the commonest histological diagnosis (71.4%, n=90). Pre-operative radiological staging underestimated the tumour's stage in 27.0% (n=34) of cases. A majority had Stage IA disease (51.6%, n=65) according to TNM Classification 8th Edition, and these patients had the best 2-year survival at 96.9% (n=63). Overall survival was 87.3% at two years. At the time of data analysis 26.2% of patients (n=33) had died. Most commonly, death was attributed to progression of malignancy (57 .6%, n=19). Our study identified recurrent disease in 40.5% (n=51) of patients, with a progression free survival (PFS) of 34.4 months. 70.6% (n=24) of wedge resections were carried out in Stage IA disease. PFS was 49.5 months for lobectomy vs 48.9 months for wedge resections of Stage IA disease. 28.6% (n=36) of patients had a second malignancy, with the most common being colorectal (22.2%, n=8).

Our results correlate well with international data regarding survival and outcomes postlobectomy and limited resection in Stage IA disease. There is limited data regarding the incidence of other primary tumours in patients with early-stage lung cancer.