To analyse operative mortality, morbidity and factors influencing long term survival in patients who underwent sleeve pneumonectomy for primary NSCLC.
Retrospective study including 42 patients who underwent sleeve pneumonectomy for primary NSCLC in the period 1995-2004. Survival, operative mortality and morbidity were analysed and compared with control group of extended resections in the same period. Particular analysis of the influence of the N-factor to survival was done. Statistics: X-square test, survival analysis using the Kaplan-meier method.
In the analysed group, 39 pts. underwent right and 3 one-stage left sleeve pneumonectomy (M:F ratio 6:1). Compared to the period 1995-2002 with 36 pts, after inclusion of additional 6 pts. till 2004, operative mortality decreased from 19.44% to 16.66%. Operative morbidity was 26.19%. Before inclusion of the last 6 pts, 3 and 5-year survival was 27.7% and 11.1% respectively. Two of the new 6 pts. are still alive two years after the operation, whilst two of them died 7 and 7.5 months after the operation from cancer dissemination. Additional two survived more than one year and are still alive. There were no long term survivors with N2 disease.
Sleeve pneumonectomy can be done with acceptable mortality that should be well below 15%. Nevertheless, we support the attitude that such an operation is justified only if associated with 5-year survival of at least 20%.
detailed preoperative assessment in order to assess N-component is mandatory to achieve optimal patient selection for this type of lung resection.
Dragan Subotic, None.