Abstract
Objective: Surgery for postoperative locoregional recurrence is possible in up to 4% of patients. However, the patient selection remains a major challenge.
Methods: retrospective study including patients with completion pneumonectomy after previous lung resection with curative intent in a recent 10-years period.
Results: in the analysed period, 19patients underwent a completion pneumonectomy 13 right-sided, 6 left-sided, 6-60 months after previous operation. They account for around 0.8% of all patients operated for primary lung cancer in the same period. In 17 patients, previous lobectomy was done, whilst two patients underwent a sublobar resection. After the first operation, N0 and N lesions existed in 9 and 10 patients, respectively. There were no patients with N2 lesion at first operation. After the first operation, 8(42.1% ) patients were classified as disease stage I; stages II and III existed in 9(47.3%) and 2(10.6%) patients, respectively. After the completion pneumonectomy,in the majority of patients (42.15%), the stage IIIA existed. The difference in the stage distribution at first and second operation was statistically significant. Three-year and 5-year survival was : 43.7% and 25% respectively. Bronchopleural fistula occurred in two patients (10%)Two patients (10%) died within the first 6 postoperative months due to disease progression. The quality of life of the rest of patients was comparable with patients after standard pneumonectomy.
Conclusion: completion pneumonectomy can be an option for relapse treatment only in patients in good general condition, provided distant spread is excluded.
- Copyright ©the authors 2016