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[Pericardial and pulmonary vascular involvement].

V Beltrami1, E Mascitelli, M Basile

  • 1Istituto di Clinica Chirurgica Generale, Università di Chieti.

Annali Italiani Di Chirurgia
|January 1, 1990
PubMed
Summary

Lung cancer resections show higher mortality and recurrence rates after pericardial operations, especially in advanced stages. Aggressive surgical approaches in later-stage lung cancer impact patient outcomes.

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Area of Science:

  • Thoracic surgery
  • Surgical oncology
  • Pulmonary medicine

Context:

  • Analysis of over 500 lung resections from 1570 lung cancer cases.
  • Focus on histology, staging, and surgical approach in resected lung cancer patients.

Purpose:

  • To evaluate the impact of surgical approach, specifically pneumonectomy with or without pericardial resection, on outcomes in lung cancer patients.
  • To analyze differences in histology, staging, early mortality, complications, and late results based on surgical intervention.

Summary:

  • Squamous cell carcinoma was the most frequent histology (348 cases), followed by adenocarcinoma (107).
  • A significant portion of patients (40.9%) were in Stage III, with a specific focus on T3N0M0 cases.
  • Pneumonectomy was performed in 192 patients, with 68 requiring intrapericardial great vessel section and 16 undergoing pericardial resection.

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  • Patients with pericardial resection experienced higher early mortality, ECG disturbances, and 5-year recurrence rates, attributed to advanced disease stage necessitating aggressive surgery.

    • Impact:

    • Findings suggest that pericardial resection during pneumonectomy for lung cancer is associated with poorer outcomes.
    • The stage of lung cancer appears to be a critical factor influencing the need for aggressive surgical procedures and subsequent results.
    • Highlights the importance of considering surgical extent and patient stage in predicting outcomes for lung cancer surgery.