Completion pneumonectomy for patients with recurrent lung cancer: the impact of microvessel density on outcome

The effectiveness of performing completion pneumonectomy (CP) to treat recurrent lung cancer was assessed in 11 patients, 6 of whom had intrapulmonary recurrence, and 5, locoregional recurrence. The pathological types of cancer were adenocarcinoma in 5 patients, squamous cell carcinomas in 5 patients, and adenoid cystic carcinoma in 1 patient. The pathological stages of the recurrent lung cancer were stage I in 8 patients, stage II in 2 patients, and stage IV in 1 patient. The microvessels in the tumors were also examined and the results compared with those in the microvessels of 61 nonrecurrent tumors. The 1- and 3-year overall survival rates after CP were 54.5% and 27.3%, respectively. The vessel densities within primary and correspondent recurrent tumors were able to be assessed in 9 patients and found to be significantly greater compared with the mean value for the nonrecurrent tumors (P < 0.0001). The vessel densities in the primary and recurrent tumors of 2 of 3 long-term survivors were found to be relatively low. These results indicate the high-grade malignant potential of recurrent tumors, which led us to conclude that the use of CP should be carefully evaluated in patients with recurrence. Assessing the vasculature in primary tumors may be a useful indicator for determining which patients could benefit from CP.