Pneumonectomy for Pediatric Tumors-a Pediatric Surgical Oncology Research Collaborative Study

Area of Science:

• Pediatric Surgical Oncology
• Thoracic Surgery
• Cancer Outcomes Research

Background:

• Pneumonectomy in adults is linked to high morbidity and mortality.
• Limited data exists on pneumonectomy for pediatric tumors.

Purpose of the Study:

• To describe the utilization and long-term outcomes of pneumonectomy in children and adolescents with cancer.
• To identify factors influencing survival after pneumonectomy in pediatric cancer patients.

Main Methods:

• Retrospective review of 38 pediatric patients (<21 years) undergoing pneumonectomy for tumors (1990-2017).
• Data collected on clinical information, operative complications, functional status, recurrence, and survival.
• Statistical analysis included univariate log rank and multivariable Cox analyses.

Main Results:

• 38 patients (mean age 12 years) underwent pneumonectomy for primary (68%) or metastatic (32%) tumors.
• Lower procedure-related morbidity and mortality observed compared to adult data.
• Survival was significantly worse for patients with metastatic indications (HR=3.37, P=0.045), especially osteosarcoma.

Conclusions:

• Pneumonectomy in pediatric cancer patients has decreased morbidity and mortality compared to adults.
• Preoperative metastatic disease, particularly osteosarcoma, is associated with poorer survival outcomes.