Completion pneumonectomy. A retrospective analysis of indications and results.
Between 1970 and 1993, 446 patients underwent pneumonectomy. Completion pneumonectomy was performed in 37 patients (8.3%): 34 men and 3 women, with a mean age of 61 years (range 20-78 years). Indications were benign disease in 4 patients and carcinoma in 33. Of the latter, 21 patients underwent resection for metachronous lung cancer, 6 for recurrent lung cancer, 4 for previous incomplete resection, 1 for primary lung cancer after previous resection for benign disease and 1 patient after previous segmentectomy for metastasis. The mean interval between first operation and completion pneumonectomy was 41 months (range 1-187 months) for the whole group, 30 months for benign disease and 42 months for carcinoma. The overall operative mortality was 6/37 (16.2%); 1/4 patients with benign disease and 5/33 (15.2%) patients with carcinoma. Nine patients (29%) had one or more major non-fatal complication. Actuarial 3- and 5-year survival rates were 41.0% and 24.5% for the entire group, 75% at both times for patients with benign disease, 36.4% and 18.3% for all patients with carcinoma at the time of completion pneumonectomy and 24.3% and 14.5% for patients with metachronous or recurrent lung cancer. For 15 patients with stage I or II metachronous lung cancer, the 3- and 5-year survival rates were 33.9% and 16.9%. All six patients with stage III metachronous cancer died within 18 months. In conclusion, completion pneumonectomy carries a high operative mortality and morbidity. Long-term survival is negatively influenced by stage III lung cancer.
Verhagen
A F
AF
Department of Thoracic and Cardiac Surgery, University Hospital St. Radboud, Nijmegen, The Netherlands.
Lacquet
L K
LK
D000328:Adult; D000368:Aged; D004653:Empyema / Q000209:etiology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000503:physiopathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000503:physiopathology; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate