Abstract

The observation of different cancers simultaneously in the same organism is not a frequently encountered situation. Description of a synchronous second lung cancer in a case with lung cancer is called synchronous lung cancer. Determination of a new lung cancer in the period following curative surgical treatment of primary lung cancer is called metachronous lung cancer. Multiple primary lung cancer (MPLC) is a complex subject. This results from difficulty of diagnosis, the fact that the classification used for cancer does not reflect the biological condition of the tumor and limited resections’ being inevitable in treatment. This complexity increases if the lesion is of the same cell type. In most of the MPLCs, same cell type has been observed. As in the case of primary lung cancer, treatment of MPLC is a complete resection as well. Before surgical treatment, it should be proven that there is no mediastinal involvement and distant metastasis. The respiratory reserve of the patient determines the possibility of the surgical procedure. Although wide surgical resection is recommended, it is not always possible. In synchronous lung cancer, prognosis is poor after surgical resection. It has been proven that surgical treatment increases survival in metachronous lung cancer. It has been agreed that the time between primary lung cancer treatment and the description of metachronous lung cancer is at least two years, though it is yet to be contraversial. During surgical treatment of the primary tumor, sleeve lobectomies as to protect the tissue should be taken into consideration. Hence, by protecting the pulmonary reserve, the possibility of performing a complete resection will increase when metachronous lung cancer develops. In cases where wide resection cannot be performed, limited resection should be carried out. Although more experience is required for synchronous tumors, outstanding survival rates have been reached in metachronous lung cancer, within acceptable mortality limits, by means of aggressive surgical approaches.