title: Surgical results and long-term follow-up of T(4)-non-small cell lung cancer invading the left atrium or the intrapericardial base of the pulmonary veins.
abstract: Patients with locally advanced non-small cell lung cancer infiltrating the left atrium (LA) or the intrapericardial base of the pulmonary veins (PVs) are generally not considered good candidates for surgery because of the poor long-term survival. In the last 10 years, 31 consecutive patients with non-small cell lung cancer directly invading the LA or the intrapericardial base of the PVs underwent surgery. Pneumonectomy was the operation performed most frequently. In-hospital mortality was 9.7% and overall morbidity was 52%. One-, 2- and 3-year survival rates were 64, 46 and 30%, respectively with a mean survival of 22 months. The systemic recurrence of disease was the major cause of death at follow-up. At statistical analyses, the N-factor and the type of operation were related to poor long-term survival. In these patients, surgery could be performed with an acceptable operative mortality and morbidity. Surgery should be considered whenever a complete resection is technically possible. A careful preoperative evaluation is mandatory to select good candidates for surgery.
authors.affiliation: Thoracic Surgery Unit, S. Orsola-Malpighi Hospital,  University of Bologna, Bologna,  Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Stella
authors.forename: Andrea
authors.initials: A
authors.lastname: Dell'Amore
authors.forename: Guido
authors.initials: G
authors.lastname: Caroli
authors.forename: Giampiero
authors.initials: G
authors.lastname: Dolci
authors.forename: Nicola
authors.initials: N
authors.lastname: Cassanelli
authors.forename: Giulia
authors.initials: G
authors.lastname: Luciano
authors.forename: Fabio
authors.initials: F
authors.lastname: Davoli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome