Is Pneumonectomy Obsolete? Our Experience in the Current Clinical Landscape

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Pneumonectomy's role has decreased due to lung-sparing techniques and multimodal therapies.
• High morbidity and mortality associated with pneumonectomy necessitate careful patient selection.
• The study assesses the current relevance of pneumonectomy in a tertiary cancer center in India.

Purpose of the Study:

• To evaluate the current clinical relevance of pneumonectomy.
• To analyze patient demographics, clinic-pathological characteristics, and outcomes of pneumonectomy.
• To assess postoperative complications and survival rates following pneumonectomy.

Main Methods:

• Retrospective analysis of pneumonectomy cases from January 2015 to March 2024.
• Inclusion of all patients undergoing pneumonectomy at a tertiary cancer center in India.
• Analysis of demographics, clinic-pathological data, postoperative outcomes, and survival.

Main Results:

• 19 out of 412 major lung resections (4.6%) were pneumonectomies.
• Lung cancer (78.9%) was the primary indication, followed by carcinoid tumors and inflammatory conditions.
• Postoperative complications occurred in 26.3% of patients, with an in-hospital mortality of 10.5%.

Conclusions:

• Pneumonectomy remains essential for specific cases, particularly in the Indian context with prevalent locally advanced lung cancer and inflammatory lung damage.
• Advances in lung-sparing surgery and alternative treatments have reduced pneumonectomy rates.
• Meticulous perioperative management can achieve acceptable outcomes for pneumonectomy patients.