expected number of different tumour types was calculated according to age group, gender and observation time. RESULTSOf the 1425 patients, 228 (16%) had one, 23 (1.6%) had two, three (0.2%) had three and one (0.07%) had four other primary malignancies. In all, 100 (34.8%) of the other tumours were diagnosed as antecedent, 53 (18.7%) as synchronous and 134 (46.7%) as subsequent to the RCC. Cancer in the prostate, bladder, lung, breast, colon and rectal cancer, malignant melanomas (MM) and non-Hodgkin's lymphomas (NHL) were the most common other malignancies. The observed overall number of subsequent other malignant tumours was 22% higher than the expected number. The observed number of subsequent tumours was significantly higher for bladder cancer, NHL and MM. The estimated 15-year cumulative risk for patients with RCC and no previous or synchronous other malignancy for developing a later second cancer was 26.6% in men, and 15.5% in women (statistically significant, P = 0.04). Patients with antecedent or synchronous other cancer had significantly poorer overall survival than those without. CONCLUSIONSPatients with RCC seem to have a significantly higher risk of developing other subsequent primary malignancies. This should be considered during the follow-up of patients with RCC.

Lung cancer surgery appears to be a relatively safe procedure even in the elderly. There is a high postoperative mortality after bilobectomy and pneumonectomy. However, when old people survive the postoperative period the long term prognosis seems favorable.

In this population-based, unselected series, the postoperative mortality was relatively high, and increased markedly in patients older than 70 years. Pneumonectomy in patients older than 70 years should only be performed when heart-lung function is found to be acceptable following full pulmonary function testing and thorough preoperative assessment of cardiovascular risk factors.

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