Completion pneumonectomy forlung metastases: Is it justified?

Dominique Grunenwald, Lorenzo Spaggiari, Philippe Girard, Pierre Baldeyrou, Marc Filaire, George Dennewald

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the postoperative outcome and long-term results of patients who underwent iterative and extended pulmonary resection leading to completion pneumonectomy for pulmonary metastases. Methods: From January 1985 to December 1995, 12 patients (mean age 45 years) underwent completion pneumonectomy for pulmonary metastases. These patients represent 1.5% of all pulmonary metastases operated on. There were 5 sarcoma and 7 carcinoma patients. Before completion pneumonectomy, 8 patients had only one pulmonary resection (wedge resection, 2; segmentectomy, 2; lobectomy, 4), 3 patients had two operations and finally, 1 patients had multiple bilateral wedge resection and 1 lobectomy. The median interval time between the last pulmonary resection and completion pneumonectomy was 13.5 months (range 1-24 months). Results: There were 10 left and two right completion pneumonectomies. Three patients had an extended resection (1 carina; 1 chest wall; 1 pleuropneumonectomy). Intrapericardial dissection was used in 3 patients. Two patients died within 30 days of the operation: 1 died of postoperative complications (8.3% whereas) the other died of rapidly evolving metastatic disease. The remaining 10 patients had an uneventful postoperative course. Only 1 patient is still alive and free of disease 69 months after completion pneumonectomy. One patients is alive with disease, another was lost to follow-up; 9 patients died of meetastatic disease. The median survival time after completion pneumonectomy was 6 months (range 0-69 months). The estimated 5-year probability of survival was 10% (95% CI: 2- 40%). Conclusions: Indications for both iterative and extended pulmonary resection for PM may be discussed only in highly young selected patients; the extremely poor outcome of our subgroup of patients should lead to even more restrictive indications of CP for pulmonary metastatic disease.

Original languageEnglish
Pages (from-to)694-697
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Volume12
Issue number5
DOIs
Publication statusPublished - Nov 1997

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Pneumonectomy
Neoplasm Metastasis
Lung
Survival
Segmental Mastectomy
Lost to Follow-Up
Thoracic Wall
Sarcoma

Keywords

  • Completion pneumonectomy
  • Extended resection
  • Pneumonectomy
  • Pulmonary metastasis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Completion pneumonectomy forlung metastases : Is it justified? / Grunenwald, Dominique; Spaggiari, Lorenzo; Girard, Philippe; Baldeyrou, Pierre; Filaire, Marc; Dennewald, George.

In: European Journal of Cardio-thoracic Surgery, Vol. 12, No. 5, 11.1997, p. 694-697.

Research output: Contribution to journalArticle

Grunenwald, Dominique ; Spaggiari, Lorenzo ; Girard, Philippe ; Baldeyrou, Pierre ; Filaire, Marc ; Dennewald, George. / Completion pneumonectomy forlung metastases : Is it justified?. In: European Journal of Cardio-thoracic Surgery. 1997 ; Vol. 12, No. 5. pp. 694-697.
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title = "Completion pneumonectomy forlung metastases: Is it justified?",
abstract = "Objective: To evaluate the postoperative outcome and long-term results of patients who underwent iterative and extended pulmonary resection leading to completion pneumonectomy for pulmonary metastases. Methods: From January 1985 to December 1995, 12 patients (mean age 45 years) underwent completion pneumonectomy for pulmonary metastases. These patients represent 1.5{\%} of all pulmonary metastases operated on. There were 5 sarcoma and 7 carcinoma patients. Before completion pneumonectomy, 8 patients had only one pulmonary resection (wedge resection, 2; segmentectomy, 2; lobectomy, 4), 3 patients had two operations and finally, 1 patients had multiple bilateral wedge resection and 1 lobectomy. The median interval time between the last pulmonary resection and completion pneumonectomy was 13.5 months (range 1-24 months). Results: There were 10 left and two right completion pneumonectomies. Three patients had an extended resection (1 carina; 1 chest wall; 1 pleuropneumonectomy). Intrapericardial dissection was used in 3 patients. Two patients died within 30 days of the operation: 1 died of postoperative complications (8.3{\%} whereas) the other died of rapidly evolving metastatic disease. The remaining 10 patients had an uneventful postoperative course. Only 1 patient is still alive and free of disease 69 months after completion pneumonectomy. One patients is alive with disease, another was lost to follow-up; 9 patients died of meetastatic disease. The median survival time after completion pneumonectomy was 6 months (range 0-69 months). The estimated 5-year probability of survival was 10{\%} (95{\%} CI: 2- 40{\%}). Conclusions: Indications for both iterative and extended pulmonary resection for PM may be discussed only in highly young selected patients; the extremely poor outcome of our subgroup of patients should lead to even more restrictive indications of CP for pulmonary metastatic disease.",
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AU - Dennewald, George

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AB - Objective: To evaluate the postoperative outcome and long-term results of patients who underwent iterative and extended pulmonary resection leading to completion pneumonectomy for pulmonary metastases. Methods: From January 1985 to December 1995, 12 patients (mean age 45 years) underwent completion pneumonectomy for pulmonary metastases. These patients represent 1.5% of all pulmonary metastases operated on. There were 5 sarcoma and 7 carcinoma patients. Before completion pneumonectomy, 8 patients had only one pulmonary resection (wedge resection, 2; segmentectomy, 2; lobectomy, 4), 3 patients had two operations and finally, 1 patients had multiple bilateral wedge resection and 1 lobectomy. The median interval time between the last pulmonary resection and completion pneumonectomy was 13.5 months (range 1-24 months). Results: There were 10 left and two right completion pneumonectomies. Three patients had an extended resection (1 carina; 1 chest wall; 1 pleuropneumonectomy). Intrapericardial dissection was used in 3 patients. Two patients died within 30 days of the operation: 1 died of postoperative complications (8.3% whereas) the other died of rapidly evolving metastatic disease. The remaining 10 patients had an uneventful postoperative course. Only 1 patient is still alive and free of disease 69 months after completion pneumonectomy. One patients is alive with disease, another was lost to follow-up; 9 patients died of meetastatic disease. The median survival time after completion pneumonectomy was 6 months (range 0-69 months). The estimated 5-year probability of survival was 10% (95% CI: 2- 40%). Conclusions: Indications for both iterative and extended pulmonary resection for PM may be discussed only in highly young selected patients; the extremely poor outcome of our subgroup of patients should lead to even more restrictive indications of CP for pulmonary metastatic disease.

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