RT Journal Article SR Electronic T1 Surgery of remnant lung after contralateral pneumonectomy is safe JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA2298 DO 10.1183/13993003.congress-2021.PA2298 VO 58 IS suppl 65 A1 Katarzyna Furrer A1 Emil Iliev A1 Walter Weder A1 Sven Hillinger A1 Didier Schneiter A1 Ilhan Inci A1 Isabelle Opitz YR 2021 UL http://erj.ersjournals.com/content/58/suppl_65/PA2298.abstract AB Objective: Surgery of the residual lung after contralateral pneumonectomy for progressing non-small cell lung cancer (NSCLC) is challenging because of high risk of the second procedure and uncertain longterm results. We aimed to assess the safety of surgery in this patientgroup.Methods: Retrospective chart review was was carried out on patients undergoing surgery of remnant lung after contralateral pneumonectomy between 2001-2020. 10 right-/leftsided anatomical- and 10 extended pneumonectomies were performed with 85% R0 rate. 13 NSCLC and 7 other tumors were diagnosed.Results: Median age was 61 (20-77) years, 55% females. The resection of the contralateral lung (18 wedge resections, 1 chest wall resection, 1 partial pleurectomy) was performed 18.5 months later (0–142) with 30- and 90 day 5% and 10% mortality. Morbidity after second surgery in 10/20 patients was predominantly caused by grade I minor (7/20) complications. Histology revealed 12 metastases, 4 secondary primary, 2 benign lesions and 2 patients with a synchronous- respective metachronous tumors. The overall survival (OS) and progression-free survival (PFS) were 37 [95%CI: 20,54] and 13 [95%CI: 0,38] months, respectively. The time interval between surgeries: more 12 months versus less than 12 months (9/14 vs 5/6 deaths) and complete (R0) resection of the primary tumor versus R1/R2 resection belonged to the factors influenced OS and PFS (fig).Conclusions: Lung resection in the remaining lung after pneumonectomy can be performed in selected patients with acceptable morbidity and mortality. The prognosis is poor for patients with incomplete resection for the primary tumor and for those treated by second surgery earlier than 12 months after the pneumonectomy.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2298.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).