Abstract

Objective:

Although the preference is to avoid pneumonectomy as much as possible for the surgical resection of Non-small cell lung cancer (NSCLC), in some instances pneumonectomy must be consid­ered among the treatment choices. We aimed to evaluate the surgical results of pneumonectomy and lobectomy for lung cancer.

Methods:

The patients who underwent lobectomy or pneumonectomy for pri­mary NSCLC between January! 995 and June 2004 were studied and compared in the aspects of patients’ characteristics, complication, 5- year survival, and recurrence rates.

Results:

Ninety-four percent of 236 patients was male. Mean age was 59.2 (range 37-76). Lobec­tomy was performed in 68.2% of all patients while the rest had had pneumonectomy. Complete resection was achieved in 95.8%. The cu­mulative 5-year survival rate was 44.4%. The rates of operative mor­tality, complications, and recurrences in follow-up were 1.9%, 40.4%, 42.9%, respectively in lobectomy group and 4.0%, 29.3%, 32.0%, respectively in pneumonectomy group. The 5-year survival rates were 40.0% and 58.8%, respectively in lobectomy and pneumonectomy groups. The difference between two groups was significant (p=0.02), conversely in complication and total recurrence rates. Local recur­rence rate was 19.9% in lobectomy group and 4.0% in pneumonec­tomy group (p=0.006). Survival rate was higher in pneumonectomy for symptomatic, male, T3, N1 and stage IIB cases (p values<0.05).

Conclusions:

By considering higher survival and lower local recur­rence rates than lobectomy group, pneumonectomy might be a good choice for the management of highly selected patients such as with stage IIB or N1 diseases, and for the patients who could tolerate pneu­monectomy.