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The Annals of Thoracic Surgery, Vol 52, 1096-1101, Copyright © 1991 by The Society of Thoracic Surgeons
PE Van Schil, A Brutel de la Riviere, PJ Knaepen, HA van Swieten, JJ Defauw and JM van den Bosch
From 1960 to 1989, 145 patients (132 men and 13 women) with a mean age of
60.3 years underwent sleeve lobectomy or sleeve resection of a main
bronchus for a bronchogenic tumor. Squamous cell carcinoma was
predominantly found (116 patients, 80.0%), followed by carcinoid tumor in
13 patients (9.0%). Postoperative staging was: stage I, 61 patients
(42.1%); stage II, 47 (32.4%); stage IIIA, 33 (22.8%); and stage IIIB, 4
(2.7%). Thirty-day mortality was 4.8% (7 patients). Follow-up was complete
except for 1 patient who was lost to follow-up 4 years after operation. For
the whole group, 5-, 10-, and 15-year survival rates were 49%, 37%, and
18%, respectively. Better survival was noted in patients with carcinoid
tumor and squamous cell carcinoma. Considering 112 patients with T2 and T3
squamous cell carcinoma, 5- and 10-year survival rates for N0 disease (52
patients) were 59% and 47%, for N1 disease (51 patients) 21% and 0%, and
for N2 disease (9 patients) 44% and 0%. Differences between N1 and N2
disease were not statistically significant. Survival after sleeve resection
is best for carcinoid tumors and squamous cell carcinoma with negative
nodes. Presence of N1 or N2 disease significantly worsens prognosis, with
no 10-year survivors and no difference between N1 and N2 status.
ARTICLES
TNM staging and long-term follow-up after sleeve resection for bronchogenic tumors
Department of Thoracic Surgery, Antoniushospital, Nieuwegein, Netherlands.
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