Pneumonectomy - Permanent Injury or Still Effective Method of Treatment? Early and Long-term Results and Quality of Life After Pneumonectomy Due to Non-small Cell Lung Cancer

Overview

Journal Kardiochir Torakochirurgia Pol

Publisher Termedia

Date 2019 May 3

PMID 31043969

Citations 5

Authors

Piotr J Skrzypczak

Magdalena Roszak

Mariusz Kasprzyk

Anna Kopczynska

Piotr Gabryel

Wojciech Dyszkiewicz

Affiliations

Soon will be listed here.

Abstract

Introduction: Despite the constant decrease of performed pneumonectomies (PN) in recent years, it is still necessary for 15-20% of patients with non-small cell lung cancer (NSCLC) to undergo total lung resection due to the local progression of the disease.

Aim: To assess the frequency and type of postoperative complications, quality of life, and the early and long-term results after PN performed due to NSCLC.

Material And Methods: In the total group of 1160 patients, operated on in 2008-2011 due to NSCLC, 192 of them underwent PN (16.6%). The quality of life was analysed using EORTC-QLQ-C30 questionnaire.

Results: Perioperative mortality after PN was 4%. Five-year survival reached 45%. The factors that significantly affected the 5-year survival in multivariate analysis were: pTNM stage, pN stage, intrapericardial resection, and additional extrapulmonary structures resection. The mean Global Quality of Life was 50.8. The Symptom Scale ranged from 7 to 54.3, the Functional Scale from 58.2 to 76.3 and the rate for NSCLC symptoms ranged from 2.2 to 48.1.

Conclusions: Pneumonectomies in patients with NSCLC is associated with higher risk of postoperative complications but it does not significantly increase the perioperative mortality. Long-term results in this group of patients are encouraging. According to the questionnaire, the quality of life is favourable. Low intensity of typical NSCLC symptoms was observed. The appropriate qualification for right-sided PN and exclusion of metastasis in N2 nodes are crucial.

Citing Articles

Enhancing Patient Selection in Stage IIIA-IIIB NSCLC: Invasive Lymph Node Restaging after Neoadjuvant Therapy.

Kwiatkowski R, Zielinski M, Paluch J, Gabor J, Swinarew A J Clin Med. 2024; 13(2).

PMID: 38256555 PMC: 10816301. DOI: 10.3390/jcm13020422.

The review of the management and prevention methods of bronchopleural fistula in thoracic surgery.

Skrzypczak P, Kasprzyk M, Piwkowski C J Thorac Dis. 2023; 15(10):5268-5271.

PMID: 37969259 PMC: 10636441. DOI: 10.21037/jtd-23-1231.

Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients.

Nitsche L, Jordan S, Demmy T, Dexter E, Hennon M, Nwogu C J Thorac Dis. 2023; 15(5):2497-2504.

PMID: 37324102 PMC: 10267906. DOI: 10.21037/jtd-22-654.

Postoperative Symptom Burden in Patients Undergoing Lung Cancer Surgery.

Merlo A, Carlson R, Espey 3rd J, Williams B, Balakrishnan P, Chen S J Pain Symptom Manage. 2022; 64(3):254-267.

PMID: 35659636 PMC: 10744975. DOI: 10.1016/j.jpainsymman.2022.05.016.

[Pneumonectomy for Non-small Cell Lung Cancer: Predictors of Operative Mortality and Survival].

Guo X, Wang H, Wei Y Zhongguo Fei Ai Za Zhi. 2020; 23(7):573-581.

PMID: 32702791 PMC: 7406439. DOI: 10.3779/j.issn.1009-3419.2020.101.06.

References

Deslauriers J, Ugalde P, Miro S, Deslauriers D, Ferland S, Bergeron S . Long-term physiological consequences of pneumonectomy. Semin Thorac Cardiovasc Surg. 2011; 23(3):196-202. DOI: 10.1053/j.semtcvs.2011.10.008. View

Andersson S, Rauma V, Sihvo E, Rasanen J, Ilonen I, Salo J . Bronchial sleeve resection or pneumonectomy for non-small cell lung cancer: a propensity-matched analysis of long-term results, survival and quality of life. J Thorac Dis. 2015; 7(10):1742-8. PMC: 4635262. DOI: 10.3978/j.issn.2072-1439.2015.10.62. View

Ludwig C, Stoelben E, Olschewski M, Hasse J . Comparison of morbidity, 30-day mortality, and long-term survival after pneumonectomy and sleeve lobectomy for non-small cell lung carcinoma. Ann Thorac Surg. 2005; 79(3):968-73. DOI: 10.1016/j.athoracsur.2004.08.062. View

Albain K, Swann R, Rusch V, Turrisi 3rd A, Shepherd F, Smith C . Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet. 2009; 374(9687):379-86. PMC: 4407808. DOI: 10.1016/S0140-6736(09)60737-6. View

Pages P, Mordant P, Renaud S, Brouchet L, Thomas P, Dahan M . Sleeve lobectomy may provide better outcomes than pneumonectomy for non-small cell lung cancer. A decade in a nationwide study. J Thorac Cardiovasc Surg. 2016; 153(1):184-195.e3. DOI: 10.1016/j.jtcvs.2016.09.060. View

Suen H, Hendrix H, Patterson G . Physiologic consequences of pneumonectomy. Consequences on the esophageal function. Chest Surg Clin N Am. 1999; 9(2):475-83, xiii. View

Ramnath N, Demmy T, Antun A, Natarajan N, Nwogu C, Loewen G . Pneumonectomy for bronchogenic carcinoma: analysis of factors predicting survival. Ann Thorac Surg. 2007; 83(5):1831-6. DOI: 10.1016/j.athoracsur.2006.12.036. View

Ferguson M, Vigneswaran W . Changes in patient presentation and outcomes for major lung resection over three decades. Eur J Cardiothorac Surg. 2008; 33(3):497-501. DOI: 10.1016/j.ejcts.2007.12.023. View

NAGASAKI F, Flehinger B, Martini N . Complications of surgery in the treatment of carcinoma of the lung. Chest. 1982; 82(1):25-9. DOI: 10.1378/chest.82.1.25. View

10.

Stoelben E, Sauerbrei W, Ludwig C, Hasse J . Tumor stage and early mortality for surgical resections in lung cancer. Langenbecks Arch Surg. 2003; 388(2):116-21. DOI: 10.1007/s00423-003-0354-x. View

11.

Balduyck B, Hendriks J, Lauwers P, Sardari Nia P, Van Schil P . Quality of life evolution after lung cancer surgery in septuagenarians: a prospective study. Eur J Cardiothorac Surg. 2009; 35(6):1070-5. DOI: 10.1016/j.ejcts.2009.01.050. View

12.

Balduyck B, Hendriks J, Lauwers P, Van Schil P . Quality of life after lung cancer surgery: a prospective pilot study comparing bronchial sleeve lobectomy with pneumonectomy. J Thorac Oncol. 2008; 3(6):604-8. DOI: 10.1097/JTO.0b013e318170fca4. View

13.

Kim D, Lee J, Lee C, Park I, Chung K . Long-term survival following pneumonectomy for non-small cell lung cancer: clinical implications for follow-up care. Chest. 2007; 132(1):178-84. DOI: 10.1378/chest.07-0554. View

14.

Fernandez F, Force S, Pickens A, Kilgo P, Luu T, Miller D . Impact of laterality on early and late survival after pneumonectomy. Ann Thorac Surg. 2011; 92(1):244-9. DOI: 10.1016/j.athoracsur.2011.03.021. View

15.

Bagan P, Le Pimpec-Barthes F, Badia A, Crockett F, Dujon A, Riquet M . Bronchial sleeve resections: lung function resurrecting procedure. Eur J Cardiothorac Surg. 2008; 34(3):484-7. DOI: 10.1016/j.ejcts.2008.05.051. View

16.

Riquet M, Mordant P, Pricopi C, Legras A, Foucault C, Dujon A . A review of 250 ten-year survivors after pneumonectomy for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2013; 45(5):876-81. DOI: 10.1093/ejcts/ezt494. View

17.

Cykert S, Kissling G, Hansen C . Patient preferences regarding possible outcomes of lung resection: what outcomes should preoperative evaluations target?. Chest. 2000; 117(6):1551-9. DOI: 10.1378/chest.117.6.1551. View

18.

Stallard J, Loberg A, Dunning J, Dark J . Is a sleeve lobectomy significantly better than a pneumonectomy?. Interact Cardiovasc Thorac Surg. 2010; 11(5):660-6. DOI: 10.1510/icvts.2010.245506. View

19.

Ilonen I, Rasanen J, Sihvo E, Aija Knuuttila , Sovijarvi A, Sintonen H . Pneumonectomy: post-operative quality of life and lung function. Lung Cancer. 2007; 58(3):397-402. DOI: 10.1016/j.lungcan.2007.07.008. View

20.

Martin-Ucar A, Chaudhuri N, Edwards J, Waller D . Can pneumonectomy for non-small cell lung cancer be avoided? An audit of parenchymal sparing lung surgery. Eur J Cardiothorac Surg. 2002; 21(4):601-5. DOI: 10.1016/s1010-7940(02)00028-3. View