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Ann Thorac Surg 2007;83:1831-1836
© 2007 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Pneumonectomy for Bronchogenic Carcinoma: Analysis of Factors Predicting Survival

^a Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
^b Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York
^c Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York
^d Department of Medicine, Jacobi Medical Center, South Bronx, New York

Accepted for publication December 18, 2006.

^_* Address correspondence to Dr Ramnath, Roswell Park Cancer Institute, Elm and Carlton St, Buffalo, NY14263 (Email: nithya.ramnath{at}roswellpark.org).

Background: The aim of this study was to identify risk factors associated with survival after pneumonectomy for non-small cell lung cancer.

Methods: This was a retrospective study of 155 patients who underwent a pneumonectomy for non-small cell lung cancer at Roswell Park Cancer Institute between 1986 and 2002. Medical record review ascertained information on preoperative assessment including pulmonary function tests and clinical characteristics, postoperative complications, and overall survival. Multivariate Cox proportional hazards models to calculate the hazard ratios and 95% confidence intervals were used. Kaplan-Meier cumulative survival curves (with log-rank p values) were generated for selected variables.

Results: The median age was 58 years at the time of surgery; 65% of patients were males. Squamous cell carcinoma (54%) and adenocarcinoma (33%) were the predominant histologic types. The median time to relapse was 11 months, and the overall median survival was 15.6 months. An American Society of Anesthesiology score of less than 3, squamous histology, and lower pathologic stage were significant independent predictors of improved survival. Current smoking status (hazard ratio = 1.87, 95% confidence interval: 1.30 to 2.70) and left tumor location (hazard ratio = 1.40, 95% confidence interval: 0.97 to 2.03) were associated with a trend toward poorer survival. Sixty-four patients (41%) had postoperative complications. The operative mortality from pneumonectomy was 9 of 155 (5.8%).

Conclusions: American Society of Anesthesiology score, histology, pathologic stage, smoking status, and location of the tumor were important predictors of survival in this patient sample. Pneumonectomy for non-small cell lung cancer carries an acceptable operative mortality and provides an important survival benefit.

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				T. Gudbjartsson, E. Gyllstedt, A. Pikwer, and P. Jonsson Early surgical results after pneumonectomy for non-small cell lung cancer are not affected by preoperative radiotherapy and chemotherapy. Ann. Thorac. Surg., August 1, 2008; 86(2): 376 - 382. [Abstract] [Full Text] [PDF]