Completion Pneumonectomy for Non-Small-Cell Lung Cancer: Does Induction Treatment Influence Postoperative Outcomes?

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Completion pneumonectomy (CP) is a complex procedure with significant morbidity and mortality risks.
• Evaluating the impact of induction treatment (IT) on postoperative outcomes and long-term results is essential.

Purpose of the Study:

• To assess the effect of induction treatment (IT) on postoperative outcomes in patients undergoing completion pneumonectomy (CP).
• To identify factors influencing long-term survival after CP.

Main Methods:

• A retrospective review of 69 lung cancer patients who underwent CP between 1998 and 2020.
• Analysis of 23 patients (33.3%) who received IT (chemotherapy, chemoradiotherapy, or radiation).
• Evaluation of postoperative complications, hospital stay, and survival rates, correlating with IT and other factors.

Main Results:

• The 30-day mortality rate was 7.2%, and overall morbidity was 37.6%.
• IT did not significantly influence postoperative morbidity or mortality.
• Overall 5-year survival was 51.7%, with IT, resection extent, histology, and pathological stage significantly impacting survival.

Conclusions:

• Completion pneumonectomy (CP) can be performed with acceptable morbidity and mortality, justifying its use.
• Postoperative complications were not affected by induction treatment (IT).
• Long-term survival is positively influenced by IT, while advanced stages, extended resections, and squamous cell carcinoma are associated with poorer outcomes.