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Suresh Krishan Yogeswaran



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    P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.18-02 - Pneumonectomy and Lung Cancer: A Treacherous Combination (ID 351)

      10:15 - 18:15  |  Author(s): Suresh Krishan Yogeswaran

      • Abstract
      • Slides

      Background

      In spite of the progress made in recent years regarding minimally invasive and parenchymal-sparing surgery, pneumonectomy is still necessary in cases where lesser resections are not possible. However, pneumonectomy remains a high-risk surgical procedure associated with significant postoperative morbidity and mortality. We investigated early and long-term results in a recent series of patients undergoing pneumonectomy for lung cancer.

      Method

      Clinical and pathological characteristics of non-small cell lung cancer (NSCLC) patients treated by pneumonectomy between January 2008 and December 2013 were retrospectively reviewed. Overall 30- and 90-day mortality and 1-, 2-, and 5-year survival rates were calculated. Postoperative complications and disease progression or recurrence were analysed by descriptive statistics. Univariate and multivariate analyses of factors related to long-term survival were also performed.

      Result

      A total of 61 patients, 48 men and 13 women with an overall mean age of 64±8.9 years, underwent pneumonectomy. The 30- and 90-day mortality rates were 6.6% and 16.4%, respectively. Ninety-day mortality was significantly correlated to tumour pathology (p=0.0410) and occurrence of postoperative complications (p=0.0078). Overall 1-, 2-, and 5-year survival rates were 70.5%, 57.4%, and 37.7%, respectively. Progressive or recurrent disease occurred in 45.7% of all patients. Most frequent early complications were atrial fibrillation (41.0%), pneumonia (23.0%), and acute respiratory failure (18.3%). survival plot pneumonectomy.jpg

      Conclusion

      Despite careful patient selection, pneumonectomy yields high mortality and morbidity rates. Therefore, it should only be performed when no other therapeutic options are available. Furthermore, rigorous preoperative work-up and risk stratification models are necessary to determine whether pneumonectomy is the most suitable treatment option and to obtain acceptable long-term results.

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