title: Short- and long-term outcomes of pneumonectomy in a tertiary center.
abstract: BACKGROUND
  Surgery is the most important therapeutic modality for lung cancer. Surgical outcomes are normally reported as 30-day or 90-day mortality or 5-year survival; 10-year survival is rarely mentioned in national data or international studies.
  
  
  METHODS
  Three hundred and six patients (79% male) underwent pneumonectomy, mainly for lung cancer, from January 1998 to February 2013. Their short- and long-term outcomes up to September 2014 were analyzed retrospectively. The mean age was 64 years (range 22-82 years) and 24% were aged ≥70 years. Thoracoscore was used to calculate the risk of hospital mortality.
  
  
  RESULTS
  Operative mortality was 4.5% whereas predicted mortality was 8%. The operative mortality for cancer patients was 3.3%; the national mortality for lung cancer is 6.5%. Only 2 patients died in hospital after a pneumonectomy in the last 5 years. Half of the patients who died in hospital were ≥70 years old; 29% (4 patients) died after urgent operations for nonmalignant disease. Overall 5- and 10-year survival was 32% and 20%. Median and mean survival was 26 and 57 months, respectively. Long-term survival was better in females aged <70 years, in left pneumonectomy patients, and in those with squamous cell lung cancer.
  
  
  CONCLUSIONS
  Our mortality for pneumonectomy was 50% less than the national mortality rate and significantly lower than that predicted by the Thoracoscore for lung cancer. This confirms that pneumonectomy is still an effective modality for the treatment of lung cancer, with low operative mortality and good long-term survival, especially in younger patients.
authors: Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK ssaq98@yahoo.com.
authors: Syed S A
authors: SS
authors: Qadri
authors: Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK.
authors: Mubarak A
authors: MA
authors: Chaudhry
authors: Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK.
authors: Alex
authors: A
authors: Cale
authors: Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK.
authors: Michael E
authors: ME
authors: Cowen
authors: Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK.
authors: Mahmoud
authors: M
authors: Loubani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D004739:England; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Carcinoma; Lung neoplasms; Pneumonectomy; Postoperative complications; Survival rate; non-small-cell lung