Lung resection for bronchogenic carcinoma after pneumonectomy:: a safe and worthwhile procedure

被引:37
作者
Terzi, A [1 ]
Lonardoni, A [1 ]
Scanagatta, P [1 ]
Pergher, S [1 ]
Bonadiman, C [1 ]
Calabrò, F [1 ]
机构
[1] Azienda Osped Verona, Osped Maggiore, Operat Unit Thorac Surg, I-37126 Verona, Italy
关键词
single lung surgery; pneumonectomy; metachronous lung cancer;
D O I
10.1016/j.ejcts.2003.12.024
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Patients treated surgically for lung cancer can develop either a metachronous cancer or a recurrence. The appearance of a new cancer on the remaining lung after a pneumonectomy poses unique treatment problems, and surgery is often considered contraindicated. We report on the outcome of resections for lung cancer after pneumonectomy performed for lung cancer. Methods: We reviewed the records of patients who underwent a resection of bronchogenic carcinoma on the remaining lung from 1990 to 2002. Results: There were 14 patients (13 males and 1 female) with a median age of 64 years (range 51-74). Median preoperative Fev1 was 1.45 (range 1.35-2.23), corresponding to 59% of predicted Fev1 (range 46-80%). Resection was performed between I I and 264 months after pneumonectomy (median 35.5). The resections performed were: one wedge resection in 11 patients, two wedge resections in two patients and two segmentectomies in two other patients; one patient underwent a third resection. Diagnosis was metachronous cancer in 12 patients and metastasis in two patients. Complications occurred in three patients (21%), while operative mortality was nil. Mean hospital stay was 10.5 days (6-25). Two patients received chemotherapy (one after local recurrence, one after the third resection). Overall 1, 3 and 5 year survivals were 57, 46 and 30%, respectively (median 21 months). For patients with a metachronous cancer they were 69, 55 and 37% (median 57 months), respectively, while neither patient with a metastatic tumor survived I year (P = 0.03). Conclusions: Limited lung resection on a single lung is a safe procedure associated with acceptable morbidity and mortality rates. In patients with a metachronous lung cancer, long-term survival with a good quality of life can be obtained with limited resection on the residual lung. (C) 2003 Elsevier B.V. All rights reserved.
引用
收藏
页码:456 / 459
页数:4
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