Completion pneumonectomy for recurrent or second primary lung cancer.
OBJECTIVE
We studied 8 patients undergoing completion pneumonectomy for recurrent or second primary lung cancer.


METHODS
Subjects were men who averaged 62 years of age. Of these 6 had p-stage I, and 2 p-stage II disease at initial operation. At the second operation, we diagnosed 3 with second primary lung cancer and 5 with recurrent lung cancer. We predicted postoperative pulmonary function by calculating the predicted forced expiratory volume in 1.0 second (FEV1.0) from residual numbers of subsegments after completion pneumonectomy. All predicted FEV1.0 in our 8 cases ranged from 544 to 926 (773 +/- 144) ml/m2.


RESULTS
Six patients experienced postoperative complications and morbidity was 75%. One patient undergoing completion sleeve pneumonectomy after radiation therapy for local carina recurrence died on 7th postoperative day due to anastomotic dehiscence and pneumonia. Overall operative mortality was 12.5% (1/8). Four remain alive and actuarial 5-year survival was 37.5%.


CONCLUSIONS
Careful consideration is needed in determining operative indications for completion pneumonectomy for patients after radiation therapy. Patients with recurrent squamous cell carcinoma who have p-stage I disease at initial operation and those with second primary lung cancer and p-stage I or II disease can expect relatively a long-term survival, and we concluded that completion pneumonectomy could be conducted in these cases with a satisfactory prognosis.
Muraoka
M
M
First Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8102, Japan.
Oka
T
T
Takahashi
T
T
Akamine
S
S
Morinaga
M
M
Nagayasu
T
T
Tagawa
Y
Y
Ayabe
H
H
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome