Lung resection for bronchogenic carcinoma after pneumonectomy

A safe and worthwhile procedure

A. Terzi, A. Lonardoni, P. Scanagatta, S. Pergher, C. Bonadiman, F. Calabrò

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objectives: Patients treated surgically for lung cancer can develop either a metachronous cancer or a recurrence. The appearance of a new cancer on the remaining lung after a pneumonectomy poses unique treatment problems, and surgery is often considered contraindicated. We report on the outcome of resections for lung cancer after pneumonectomy performed for lung cancer. Methods: We reviewed the records of patients who underwent a resection of bronchogenic carcinoma on the remaining lung from 1990 to 2002. Results: There were 14 patients (13 males and 1 female) with a median age of 64 years (range 51-74). Median preoperative Fev1 was 1.45 (range 1.35-2.23), corresponding to 59% of predicted Fev1 (range 46-80%). Resection was performed between 11 and 264 months after pneumonectomy (median 35.5). The resections performed were: one wedge resection in 11 patients, two wedge resections in two patients and two segmentectomies in two other patients; one patient underwent a third resection. Diagnosis was metachronous cancer in 12 patients and metastasis in two patients. Complications occurred in three patients (21%), while operative mortality was nil. Mean hospital stay was 10.5 days (6-25). Two patients received chemotherapy (one after local recurrence, one after the third resection). Overall 1, 3 and 5 year survivals were 57, 46 and 30%, respectively (median 21 months). For patients with a metachronous cancer they were 69, 55 and 37% (median 57 months), respectively, while neither patient with a metastatic tumor survived 1 year (P=0.03). Conclusions: Limited lung resection on a single lung is a safe procedure associated with acceptable morbidity and mortality rates. In patients with a metachronous lung cancer, long-term survival with a good quality of life can be obtained with limited resection on the residual lung.

Original languageEnglish
Pages (from-to)456-459
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Volume25
Issue number3
DOIs
Publication statusPublished - Mar 2004

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Pneumonectomy
Bronchogenic Carcinoma
Lung
Lung Neoplasms
Neoplasms
Recurrence
Survival
Segmental Mastectomy
Mortality
Length of Stay

Keywords

  • Metachronous lung cancer
  • Pneumonectomy
  • Single lung surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Lung resection for bronchogenic carcinoma after pneumonectomy : A safe and worthwhile procedure. / Terzi, A.; Lonardoni, A.; Scanagatta, P.; Pergher, S.; Bonadiman, C.; Calabrò, F.

In: European Journal of Cardio-thoracic Surgery, Vol. 25, No. 3, 03.2004, p. 456-459.

Research output: Contribution to journalArticle

Terzi, A. ; Lonardoni, A. ; Scanagatta, P. ; Pergher, S. ; Bonadiman, C. ; Calabrò, F. / Lung resection for bronchogenic carcinoma after pneumonectomy : A safe and worthwhile procedure. In: European Journal of Cardio-thoracic Surgery. 2004 ; Vol. 25, No. 3. pp. 456-459.
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abstract = "Objectives: Patients treated surgically for lung cancer can develop either a metachronous cancer or a recurrence. The appearance of a new cancer on the remaining lung after a pneumonectomy poses unique treatment problems, and surgery is often considered contraindicated. We report on the outcome of resections for lung cancer after pneumonectomy performed for lung cancer. Methods: We reviewed the records of patients who underwent a resection of bronchogenic carcinoma on the remaining lung from 1990 to 2002. Results: There were 14 patients (13 males and 1 female) with a median age of 64 years (range 51-74). Median preoperative Fev1 was 1.45 (range 1.35-2.23), corresponding to 59{\%} of predicted Fev1 (range 46-80{\%}). Resection was performed between 11 and 264 months after pneumonectomy (median 35.5). The resections performed were: one wedge resection in 11 patients, two wedge resections in two patients and two segmentectomies in two other patients; one patient underwent a third resection. Diagnosis was metachronous cancer in 12 patients and metastasis in two patients. Complications occurred in three patients (21{\%}), while operative mortality was nil. Mean hospital stay was 10.5 days (6-25). Two patients received chemotherapy (one after local recurrence, one after the third resection). Overall 1, 3 and 5 year survivals were 57, 46 and 30{\%}, respectively (median 21 months). For patients with a metachronous cancer they were 69, 55 and 37{\%} (median 57 months), respectively, while neither patient with a metastatic tumor survived 1 year (P=0.03). Conclusions: Limited lung resection on a single lung is a safe procedure associated with acceptable morbidity and mortality rates. In patients with a metachronous lung cancer, long-term survival with a good quality of life can be obtained with limited resection on the residual lung.",
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