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Ann Thorac Surg 1998;66:1930-1933
© 1998 The Society of Thoracic Surgeons

Original Articles

Pneumonectomy for lung metastases: indications, risks, and outcome

Lorenzo Spaggiari, MD, PhDa, Dominique H. Grunenwald, MDa, Philippe Girard, MDa, Piergiorgio Solli, MDa, Thierry Le Chevalier, MDa

a Department of Thoracic Surgery, Institut Mutualiste Montsouris, Paris, France

Accepted for publication June 4, 1998.

Address reprints requests to Dr Spaggiari, Department of Thoracic Surgery, European Institute of Oncology, via Ripamonti 435 20141, Milan, Italy

Background. Resection of pulmonary metastases (PM) by pneumonectomy is infrequently performed and benefits are uncertain.

Methods. From 1985 to 1995, 42 patients underwent pneumonectomy for PM. Twenty-nine patients had PM from sarcomas, 12 patients from carcinomas, and 1 patient from melanoma. The indications for pneumonectomy were pulmonary recurrences in 12 patients, PM centrally located in 26 patients, and high number of PM in 4 patients. There were 11 intrapericardial and 6 extended pneumonectomies. The average number of PM resected was 3. Twenty-two patients (52%) had lymph nodes involvement.

Results. There were 2 postoperative deaths (4.8%) related to pneumonectomy and one death within 30 days for rapidly evolving disease; 4 patients (9.5%) had major postoperative complications that were medically treated. Five patients (12%) were operated on for recurrences on the residual lung. At the completion of the study, 12 patients were still alive, 8 without recurrences. The median survival was 6.5 months (range, 1 to 144 months); the 5-year survival was 16.8%.

Conclusions. Pneumonectomy should not be considered an absolute contraindication in patients with PM, but the poor outcome of our series suggests strict criteria of selection.


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