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Pneumonectomy for non-small cell lung cancer

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Abstract

Purpose

To assess the mortality, complications and major morbidity of pneumonectomy for non-small cell lung cancer (NSCLC) and to establish the importance of various prognostic factors.

Methods

We reviewed retrospectively the hospital records of 71 consecutive patients who underwent pneumonectomy for NSCLC between 1992 and 2007 to evaluate the significance of risk factors for an adverse outcome. Patients were divided into two period groups according to the period when they were treated: early (1992–1999; n = 47) and late (2000–2007; n = 24).

Results

Both the 30-day and the in-hospital mortality rates were 4.2 % (3/71). Complications developed in 31.3 % (22/71) and overall 5-year survival was 23.1 %. Pathological stage III or more, T3 or more, and N2 or more were risk factors of an adverse outcome. Survival was not significantly influenced by histological type, the side of surgery, or curability. The 5-year survival rates for the early and late periods were 19.6 and 32.9 %, respectively. There were more patients with clinical N2 or 3 disease in the early period than in the late period (66.0 vs. 33.3 %).

Conclusions

Pneumonectomy is associated with acceptable overall morbidity and mortality; however, patients with pathological stage III or more, T3 or more, and N2 or more disease require special consideration. Pneumonectomy should be performed only in selected patients.

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Abbreviations

NSCLC:

Non-small cell lung cancer

ARDS:

Acute respiratory distress syndrome

IP:

Interstitial pneumonitis

References

  1. Kirsh MM, Rotman H, Bove E, Argenta L, Cimmino V, Tashian J, et al. Major pulmonary resection for bronchogenic carcinoma in the elderly. Ann Thorac Surg. 1976;22:369–73.

    Article  PubMed  CAS  Google Scholar 

  2. Paulson DL, Reisch JS. Long term survival after resection for bronchogenic carcinoma. Ann Surg. 1976;184:324–32.

    Article  PubMed  CAS  Google Scholar 

  3. Wilkins EW Jr, Scannell JG, Craver JG. Four decades of experience with resection for bronchogenic carcinoma at the Massachusetts General Hospital. J Thorac Cardiovasc Surg. 1978;76:364–8.

    PubMed  Google Scholar 

  4. Myrdal G, Gustafsson G, Lambe M, Horte LG, Stahle E. Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity. J Thorac Cardiovasc Surg. 2001;20:694–9.

    CAS  Google Scholar 

  5. van Meerbeeck JP, Damhuis RA, Vos de Wael ML. High postoperative risk after pneumonectomy in elderly patients with right-sided lung cancer. Eur Respir J. 2002;19:141–5.

    Article  PubMed  Google Scholar 

  6. Duque JL, Ramos G, Castrodeza J, Cerezal J, Castanedo M, Yuste MG, et al. Early complications in surgery treatment of lung cancer: a prospective, multicenter study. Ann Thorac Surg. 1997;63:944–50.

    Article  PubMed  CAS  Google Scholar 

  7. The Japan Lung Cancer Society. General rule for clinical and pathological record of lung cancer. 7th ed. Chiba: The Japan Lung Cancer Society; 2010.

  8. Birim O, Kappetein AP, Van Klaveren RJ, Bogers AJ. Prognostic factors in non-small cell lung cancer surgery. Eur J Surg Oncol. 2006;32:12–23.

    Article  PubMed  CAS  Google Scholar 

  9. Toker A, Dilege S, Ziyade S, Eroglu O, Tanju S, Yilmazbayhan D, et al. Causes of death within 1 year of resection for lung cancer. Eur J Cardiothorac Surg. 2004;25:511–9.

    Article  Google Scholar 

  10. Harpole DH, De Camp MM, Daley J, Hur K, Oprian CA, Henderson WG, et al. Prognostic models of thirty-day mortality and morbidity after major pulmonary resection. J Thorac Cardiovasc Surg. 1999;117:969–79.

    Article  PubMed  Google Scholar 

  11. Bernard A, Ferrand L, Hagry O, Benoit L, Cheynel N, Favre JP. Identification of prognostic factors determining risk groups for lung resection. Ann Thorac Surg. 2000;70:1161–7.

    Article  PubMed  CAS  Google Scholar 

  12. Lopez-Encuentra A, Pozo-Rodriguez F, Martin-Escribano P, Martín de Nicolás JL, Díaz de Atauri MJ, Palomera J, et al. Surgical lung cancer. Risk operative analysis. Lung Cancer. 2004;44:327–37.

    Article  PubMed  Google Scholar 

  13. Birim O, Kappetein AP, Bogers AJJC. Charlson comorbidity index as a predictor of long-term outcome after surgery for nonsmall cell lung cancer. Eur J Cardiothorac Surg. 2005;28:759–62.

    Article  PubMed  Google Scholar 

  14. Licker M, Spiliopoulos A, Frey JG, Robert J, Hohn L, de Perrot M, et al. Risk factors for early mortality and major complications following pneumonectomy for non-small cell carcinoma of the lung. Chest. 2002;121:1890–7.

    Article  PubMed  Google Scholar 

  15. Darling GE, Abdurahman A, Yi QL, Johnston M, Waddell TK, Pierre A, et al. Risk of a right pneumonectomy: role of bronchopleural fistula. Ann Thorac Surg. 2005;79:433–7.

    Article  PubMed  Google Scholar 

  16. Leo F, Solli PG, Veronesi G, Radice D, Floridi A, Gasparri R, et al. Does chemotherapy increase the risk of respiratory complications after pneumonectomy? J Thorac Cardiovasc Surg. 2006;132:519–32.

    Article  PubMed  Google Scholar 

  17. Reichel J. Assessment of operative risk of pneumonectomy. Chest. 1972;62:570–6.

    PubMed  CAS  Google Scholar 

  18. Ginsberg RJ, Hill LD, Eagan RT, Thomas P, Mountain CF, Deslauriers J, et al. Modern thirty-day operative mortality for surgical resection in lung cancer. J Thorac Cardiovasc Surg. 1983;86:654–8.

    PubMed  CAS  Google Scholar 

  19. Harpole DH, Liptay MJ, DeCamp MM Jr, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Prospective analysis of pneumonectomy: risk factor for major morbidity and cardiac dysrhythmias. Ann Thorac Surg. 1996;61:977–82.

    Article  PubMed  CAS  Google Scholar 

  20. Martin J, Ginsberg RJ, Abolhoda A, Bains MS, Downey RJ, Korst RJ, et al. Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg. 2001;72:1149–54.

    Article  PubMed  CAS  Google Scholar 

  21. Kopec SE, Irwin RS, Umali-Torres CB, Balikian JP, Conlan AA. The postpneumonectomy state. Chest. 1998;114:1158–84.

    Article  PubMed  CAS  Google Scholar 

  22. Wahi R, McMurtrey MJ, DeCaro LF, Mountain CF, Ali MK, Smith TL, et al. Determinants of perioperative morbidity and mortality after pneumonectomy. Ann Thorac Surg. 1989;48:33–7.

    Article  PubMed  CAS  Google Scholar 

  23. Ellie SP, Adrian CP, David C, Paul D, Ehab B, Geoffrey MRB, Fang G, UKPOS Co-ordinators. UK pneumonectomy outcome study (UKPOS): a prospective observational study of pneumonectomy outcome. J Cardiothorac Surg 2009;4:41.

    Google Scholar 

  24. Dancewicz M, Kowalewski J, Peplinski J. Factors associated with perioperative complications after pneumonectomy for primary carcinoma of the lung. Interact Cardiovasc Thorac Surg. 2006;5:97–100.

    Article  PubMed  Google Scholar 

  25. Bernard A, Deschamps C, Allen MS, Miller DL, Trastek VF, Jenkins GD, et al. Pneumonectomy for malignant disease: factors affecting early morbidity and mortality. J Thorac Cardiovasc Surg. 2001;121:1076–82.

    Article  PubMed  CAS  Google Scholar 

  26. Walter W, Stephane C, Wilfried EEE, Sven H, Stefan W, Rolf S, et al. Pneumonectomy is a valuable treatment option after neoadjuvant therapy for stage III non-small-cell lung cancer. J Thorac Cardiovasc Surg. 2010;139:1424–30.

    Article  Google Scholar 

  27. Oken MM, Creech RH, Torney DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Chest Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan

    Yoshinobu Ichiki, Akira Nagashima, Yasuhiro Chikaishi & Manabu Yasuda

Authors
  1. Yoshinobu Ichiki
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  2. Akira Nagashima
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  3. Yasuhiro Chikaishi
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  4. Manabu Yasuda
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Correspondence to Yoshinobu Ichiki.

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Ichiki, Y., Nagashima, A., Chikaishi, Y. et al. Pneumonectomy for non-small cell lung cancer. Surg Today 42, 830–834 (2012). https://doi.org/10.1007/s00595-012-0174-0

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  • DOI: https://doi.org/10.1007/s00595-012-0174-0

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