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Objectives: Separate primary cancer is defined as an independent new primary malignant tumor arising simultaneously or after the diagnosis of another neoplasm . We analyzed our results in patients with separate primary bladder and lung cancers. Design: Retrospective data review. Setting: University Hospital.
Patients: Files of patients who were previously operated on for bladder cancer and subsequently underwent lung cancer resection were identified. Patient characteristics, clinical, radiologic presentation, surgical management and survival were recorded. Histologic and immunohistochemical analysis were performed.
Results: 5 patients (4 male) were identified. Four had metachronous (17, 29, 84,162 months) and 1 had synchronous cancer. Superficial bladder cancers were identified in 4 patients . One patient had advanced stage bladder cancer. All were transitional cell carcinomas. All lung lesions were identified on a chest X-ray. 3 patients received neoadjuvant treatment. Pathologic stages were T1 NO (n=1), T2N0 (n=2), T2N1 (n=1) and T3N2 (n=1). Histologic diagnosis was squamous cell (n=3), large cell (n=1) and adenocarcinoma (n=1 ). Cytokeratin 20 was negative in 4 and thrombomodulin was negative in all patients, suggestive of primary lung cancer. Four patients are alive at 14, 24, 34 and 80 months after lung resection . One patient is alive with lung cancer recurrence and one patient died due to lung cancer at 17 months.
Conclusions: Treatment strategy of separate primary cancers should rely on clinical, radiologic and pathologic correlation. Aggressive multimodal treatment leads to a favorable outcome in these patients.