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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.