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J Thorac Oncol. 2012 Oct;7(10):1556-62. doi: 10.1097/JTO.0b013e31826419d2.

Completion pneumonectomy in patients with cancer: postoperative survival and mortality factors.

Author information

1
Thoracic Surgery Department, Hospices Civils de Lyon, Hôpital Louis Pradel, 28 avenue du doyen Lépine, Bron, France. mayeul.tabutin@chu-lyon.fr

Abstract

OBJECTIVE:

To describe postoperative complications and long-term outcomes of completion pneumonectomy and highlight prognostic factors.

METHOD:

We retrospectively reviewed the records of 46 patients (38 men, 8 women) who underwent completion pneumonectomy for lung cancer between 1995 and 2009 in one of two thoracic surgery departments. Most were current or former smokers (n = 41; 89%) and did not undergo chemotherapy (n = 38; 83%) or radiotherapy (83%) before surgery.

RESULTS:

Complications after surgery were respiratory failure (n = 11; 24.4%), bronchopleural fistula (n = 6; 13%, with no side preference), and empyema (n = 6; 13%). Blood transfusion was necessary for 43% of the cases (n = 20). The day 90 death rate was 15.2% (n = 7). Postoperative staging showed mostly limited disease. Ten patients (21.7%) underwent operation for a second primary cancer, 25 for local recurrence (54.3%), five for microscopically incomplete resection, and six for other reasons. Median overall survival after completion surgery was 30 months (median follow-up: 46.5 months). Among the 15 living patients (33%), 11 are free of disease (24%). In a Cox regression model, factors negatively influencing overall survival were: age older than 65 years (odds ratio [OR] = 2.47; p = 0.012), current smoker status (OR = 2.285; p = 0.033), postoperative pulmonary (OR = 5.144; p = 0.004), cardiac (OR = 3.404; p = 0.033), or parietal wound complications (OR = 5.439; p = 0.016).

CONCLUSION:

Despite its increased postoperative complications and mortality compared with standard pneumonectomy, completion pneumonectomy offers encouraging long-term results. Five main factors seem predictive of shorter overall survival.

PMID:
22982656
DOI:
10.1097/JTO.0b013e31826419d2
[Indexed for MEDLINE]
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