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Suresh Krishan Yogeswaran
Author of
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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
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%).
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.