Abstract
Bilobectomy for lung cancer is considered a high-risk procedure for the increased postoperative complication rate and the negative impact on survival. We analyzed the safety and the oncologic results of this procedure. We retrospectively reviewed patients who underwent bilobectomy for lung cancer between October 1998 and August 2009. Age, gender, bilobectomy type and indication, complications, pathology, stage, and survival were analyzed. Bilobectomy was performed on 146 patients (101 men; mean age, 62 years). There were 77 upper-middle and 69 middle-lower bilobectomies. Indications were tumor extending across the fissure in 27 (18.5%) patients, endobronchial tumor in 39 (26.7%), extrinsic tumor or nodal invasion of bronchus intermedius in 66 (45.2%), and vascular invasion in 14 (9.6%). An extended resection was performed in 24 patients (16.4%). Induction therapy was performed in 43 patients (29.4%). Thirty-day mortality was 1.4% (n = 2). Overall morbidity was 47.2%. Mean chest tube persistence was 7 days (range, 6 to 46 days). Overall 5-year survival was 58%. Significance differences in survival were observed among different stages (stage I, 70%; stage II, 55%; stage III, 40%; p = 0.0003) and the N status (N0, 69%; N1, 56%; N2, 40%; p = 0.0005). Extended procedure (p = 0.0003) and superior bilobectomy (p = 0.0008) adversely influenced survival. Multivariate analysis demonstrated that an extended resection (p = 0.01), an advanced N disease (p = 0.02), and an upper-mild lobectomy (p = 0.02) adversely affected prognosis. Bilobectomy is associated with a low mortality and an increased morbidity. Survival relates to disease stage and N factor. Optimal prognosis is obtained in patients with lower-middle lobectomy without extension of the resection.
| Original language | English |
|---|---|
| Pages (from-to) | 251-258 |
| Number of pages | 8 |
| Journal | Annals of Thoracic Surgery |
| Volume | 93 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2012 |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Bilobectomy for lung cancer : Analysis of indications, postoperative results, and long-term outcomes. / Galetta, Domenico; Solli, Piergiorgio; Borri, Alessandro; Petrella, Francesco; Gasparri, Roberto; Brambilla, Daniela; Spaggiari, Lorenzo.
In: Annals of Thoracic Surgery, Vol. 93, No. 1, 01.2012, p. 251-258.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bilobectomy for lung cancer
T2 - Analysis of indications, postoperative results, and long-term outcomes
AU - Galetta, Domenico
AU - Solli, Piergiorgio
AU - Borri, Alessandro
AU - Petrella, Francesco
AU - Gasparri, Roberto
AU - Brambilla, Daniela
AU - Spaggiari, Lorenzo
PY - 2012/1
Y1 - 2012/1
N2 - Bilobectomy for lung cancer is considered a high-risk procedure for the increased postoperative complication rate and the negative impact on survival. We analyzed the safety and the oncologic results of this procedure. We retrospectively reviewed patients who underwent bilobectomy for lung cancer between October 1998 and August 2009. Age, gender, bilobectomy type and indication, complications, pathology, stage, and survival were analyzed. Bilobectomy was performed on 146 patients (101 men; mean age, 62 years). There were 77 upper-middle and 69 middle-lower bilobectomies. Indications were tumor extending across the fissure in 27 (18.5%) patients, endobronchial tumor in 39 (26.7%), extrinsic tumor or nodal invasion of bronchus intermedius in 66 (45.2%), and vascular invasion in 14 (9.6%). An extended resection was performed in 24 patients (16.4%). Induction therapy was performed in 43 patients (29.4%). Thirty-day mortality was 1.4% (n = 2). Overall morbidity was 47.2%. Mean chest tube persistence was 7 days (range, 6 to 46 days). Overall 5-year survival was 58%. Significance differences in survival were observed among different stages (stage I, 70%; stage II, 55%; stage III, 40%; p = 0.0003) and the N status (N0, 69%; N1, 56%; N2, 40%; p = 0.0005). Extended procedure (p = 0.0003) and superior bilobectomy (p = 0.0008) adversely influenced survival. Multivariate analysis demonstrated that an extended resection (p = 0.01), an advanced N disease (p = 0.02), and an upper-mild lobectomy (p = 0.02) adversely affected prognosis. Bilobectomy is associated with a low mortality and an increased morbidity. Survival relates to disease stage and N factor. Optimal prognosis is obtained in patients with lower-middle lobectomy without extension of the resection.
AB - Bilobectomy for lung cancer is considered a high-risk procedure for the increased postoperative complication rate and the negative impact on survival. We analyzed the safety and the oncologic results of this procedure. We retrospectively reviewed patients who underwent bilobectomy for lung cancer between October 1998 and August 2009. Age, gender, bilobectomy type and indication, complications, pathology, stage, and survival were analyzed. Bilobectomy was performed on 146 patients (101 men; mean age, 62 years). There were 77 upper-middle and 69 middle-lower bilobectomies. Indications were tumor extending across the fissure in 27 (18.5%) patients, endobronchial tumor in 39 (26.7%), extrinsic tumor or nodal invasion of bronchus intermedius in 66 (45.2%), and vascular invasion in 14 (9.6%). An extended resection was performed in 24 patients (16.4%). Induction therapy was performed in 43 patients (29.4%). Thirty-day mortality was 1.4% (n = 2). Overall morbidity was 47.2%. Mean chest tube persistence was 7 days (range, 6 to 46 days). Overall 5-year survival was 58%. Significance differences in survival were observed among different stages (stage I, 70%; stage II, 55%; stage III, 40%; p = 0.0003) and the N status (N0, 69%; N1, 56%; N2, 40%; p = 0.0005). Extended procedure (p = 0.0003) and superior bilobectomy (p = 0.0008) adversely influenced survival. Multivariate analysis demonstrated that an extended resection (p = 0.01), an advanced N disease (p = 0.02), and an upper-mild lobectomy (p = 0.02) adversely affected prognosis. Bilobectomy is associated with a low mortality and an increased morbidity. Survival relates to disease stage and N factor. Optimal prognosis is obtained in patients with lower-middle lobectomy without extension of the resection.
UR - http://www.scopus.com/inward/record.url?scp=84055222744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84055222744&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2011.08.086
DO - 10.1016/j.athoracsur.2011.08.086
M3 - Article
C2 - 22112798
AN - SCOPUS:84055222744
VL - 93
SP - 251
EP - 258
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 1
ER -