[Safety and long-term outcome of sleeve lobectomy for non-small cell lung cancer].
OBJECTIVE
Pneumonectomy has been long term used as the standard surgical procedure for central type non-small cell lung cancer (NSCLC). Sleeve lobectomy has been performed in a small number of patients meeting the indications. This study was to compare the 5-year survival rate, operation related complications and mortality of sleeve lobectomy with pneumonectomy for NSCLC, and evaluate sleeve lobectomy in the surgical treatment for NSCLC.


METHODS
Ninety-three patients with NSCLC undergoing sleeve lobectomy (group A) and 571 patients with NSCLC undergoing pneumonectomy (group B) from January 1997 to December 2007 in Sun Yat-sen University Cancer Center were reviewed. The 5-year survival rate, operation related complications and mortality between the two groups were analyzed.


RESULTS
The overall 5-year survival for group A and group B were 42.0% and 31.5%, respectively (P=0.015). In the subgroup analysis, the 5-year survival of N0 (P=0.007) and N1 (P=0.025) patients were significant higher in group A than in group B, while the survival were not significantly different between N2 patients (P=0.073). The 5-year survival rates for bronchial and pulmonary arterial sleeve resection (the subset of group A) and pneumonectomy were not significantly different (P=0.092). There was no significant difference in local recurrences between the groups (P=0.821). The postoperative complication rates were 11.8% in group A and 20.7% in group B (P=0.046). There was no statistically significant difference in mortality between the two groups (P=0.259).


CONCLUSIONS
The operative safety and long term efficacy of sleeve lobectomy are superior to pneumonectomy for NSCLC.
Xie
Ming-Ran
MR
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Zhang
Xu
X
Lin
Peng
P
Chen
Jie-Xin
JX
Ling
Yong-Bin
YB
Fu
Jian-Hua
JH
Rong
Tie-Hua
TH
Zeng
Can-Guang
CG
Huang
Zhi-Fan
ZF
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D001980:Bronchi / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications; D015996:Survival Rate