Prognostic factors after pneumonectomy in non-small cell lung cancer

Year 2022, Volume: 3 Issue: 1, 6 - 12, 31.01.2022

Cemal Aker , Celal Buğra Sezen , Mustafa Vedat Doğru , Ali Murat Akçıl Umut Kilimci Semih Erduhan , Levent Cansever , Muzaffer Metin

Abstract

Background: This study aims to evaluate the factors affecting survival and mortality in patients who underwent pneumonectomy for non-small cell lung cancer.

Methods: The study included 241 pneumonectomy patients. Demographic data, mortality, histopathological characteristics, tumor stages, and 5-year survival rates were analyzed.

Results: The study included nine women (3.7%) and 232 men (96.3%). The patients’ mean age was 58.4±8.0 (34–81) years. Fortyfive patients (18.7%) were 65 years of age or older, and 196 patients (81.3%) were less than 65 years of age. The 30-day postoperative mortality rate was 7.9% (n=19). The only factor affecting mortality was determined as age 65 and over (p = 0.012). The median survival time was 52 months, and the 5-year survival rate was 49.4%. In multivariate analysis, advanced age, pN2 status, not receiving neoadjuvant treatment, performing sampling lymph node dissection, and not receiving adjuvant treatment were poor prognostic factors.

Conclusion: Age, pN2 status, neoadjuvant and adjuvant therapy, and lymph node dissection technique were determined as the most important prognostic factors affecting survival in patients who underwent pneumonectomy for non-small cell lung cancer. Age was the most important factor affecting mortality.

Keywords

Prognosis, Pneumonectomy, Survival Rate, Carcinoma, Non-Small-Cell Lung

Project Number

Yok

References

• 1. Yazgan S, Gursoy S, Ucvet A, Samancilar O, Erbaycu AE, Unal M, et al. Pneumonectomy; a risky type of resection in non-small cell lung cancer: survival and mortality analysis. Curr Thorac Surg. 2018;3(3).
• 2. Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568–77.
• 3. De Leyn P, Dooms C, Kuzdzal J, Lardinois D, Passlick B, Rami-Porta R, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(5):787–98.
• 4. Shapiro M, Swanson SJ, Wright CD, Chin C, Sheng S, Wisnivesky J, et al. Predictors of major morbidity and mortality after pneumonectomy utilizing the Society for Thoracic Surgeons General Thoracic Surgery Database. Ann Thorac Surg. 2010;90(3):927–35.
• 5. Schneider L, Farrokhyar F, Schieman C, Shargall Y, D’Souza J, Camposilvan I, et al. Pneumonectomy: the burden of death after discharge and predictors of surgical mortality. Ann Thorac Surg. 2014;98(6):1976–82.
• 6. Kalathiya RJ, Saha SP. Pneumonectomy for non-small cell lung cancer: outcomes analysis. South Med J. 2012;105(7):350–4.
• 7. Pekçolaklar A, Nalbant M, Metin M. The factors affecting morbidity, mortality and survival in patients who underwent intrapericardial resections due to non-small cell lung cancer. Curr Thorac Surg. 6(1).
• 8. Lee M, Razi SS. Pulmonary Sleeve Resection. StatPearls [Internet]. 2020;
• 9. Cusumano G, Marra A, Lococo F, Margaritora S, Siciliani A, Maurizi G, et al. Is sleeve lobectomy comparable in terms of short- and long-term results with pneumonectomy after induction therapy? A multicenter analysis. Ann Thorac Surg. 2014;98(3):975–83.
• 10. Parissis H, Leotsinidis M, Hughes A, McGovern E, Luke D, Young V. Comparative analysis and outcomes of sleeve resection versus pneumonectomy. Asian Cardiovasc Thorac Ann. 2009;17(2):175–82.
• 11. Pisters KMW, Vallières E, Crowley JJ, Franklin WA, Bunn PA, Ginsberg RJ, et al. Surgery with or without preoperative paclitaxel and carboplatin in early-stage non - small-cell lung cancer: Southwest oncology group trial S9900, an intergroup, randomized, phase III trial. J Clin Oncol. 2010;28(11):1843–9.
• 12. Douillard J-Y, Rosell R, De Lena M, Carpagnano F, Ramlau R, Gonzáles-Larriba JL, et al. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB–IIIA nonsmall- cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol. 2006;7(9):719–27.
• 13. Kim AW, Boffa DJ, Wang Z, Detterbeck FC. An analysis, systematic review, and meta-analysis of the perioperative mortality after neoadjuvant therapy and pneumonectomy for non-small cell lung cancer. j Thorac Cardiovasc Surg. 2012;
• 14. Berghmans T, Paesmans M, Meert AP, Mascaux C, Lothaire P, Lafitte JJ, et al. Survival improvement in resectable non-small cell lung cancer with (neo)adjuvant chemotherapy: Results of a meta-analysis of the literature. Lung Cancer. 2005 Jul 1;49(1):13–23.
• 15. Martin J, Ginsberg RJ, Abolhoda A, Bains MS, Downey RJ, Korst RJ, et al. Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg. 2001 Oct 1;72(4):1149–54.
• 16. Doddoli C, Barlesi F, Trousse D, Robitail S, Yena S, Astoul P, et al. One hundred consecutive pneumonectomies after induction therapy for non-small cell lung cancer: An uncertain balance between risks and benefits. j Thorac Cardiovasc Surg. 2005;
• 17. Mattson K V, Abratt RP, Ten Velde G, Krofta K. Docetaxel as neoadjuvant therapy for radically treatable stage III non-small-cell lung cancer: a multinational randomised phase III study. Ann Oncol. 2003;14(1):116–22.
• 18. Adachi H, Sakamaki K, Nishii T, Yamamoto T, Nagashima T, Ishikawa Y, et al. Lobe-specific lymph node dissection as a standard procedure in surgery for non–small cell lung cancer: a propensity score matching study. J Thorac Oncol. 2017;12(1):85–93.
• 19. Handa Y, Tsutani Y, Mimae T, Miyata Y, Ito H, Nakayama H, et al. Appropriate Extent of Lymphadenectomy in Segmentectomy: A Multicenter Study. Jpn J Clin Oncol. 2021;51(3):451–8.