Short-and long-term outcomes after pneumonectomy for primary lung cancer

The purpose of this study was to investigate the recent results of pneumonectomy (Pn) for primary lung cancer.

Thirty-four patients undergoing Pn and 26 patients undergoing broncho-or angioplastic lobectomy (namely, parenchyma-sparing lung resection) from January 1993 to December 2004 were reviewed. The oncological outcome of Pn was analyzed by disease-free survival (DFS). To assess morbidity and mortality, we compared the outcomes of patients undergoing Pn and parenchyma-sparing lung resection.

Five-year DFS of the Pn group was 43%. DFS of pathological stage I/II patients was significantly better than that of stage III/IV (73.3% vs. 8.5%, P = 0.0001). The occurrence of minor and major postoperative complications was not different between Pn and parenchyma-sparing lung resection (52.9% vs. 61.5%, P = 0.5054; 17.6% vs. 7.7%, P = 0.1675). In the late period, respiratory function after Pn was significantly impaired in comparison with parenchyma-sparing lung resection. Moreover, 4 noncancer-related deaths occurred in the Pn group.

The oncological outcome after Pn for patients with lung cancer of less than stage III was satisfactory. Although operative morbidity was not different between the two groups, the loss of pulmonary reserve after Pn was more severe after than the parenchyma-sparing lung resection.