Completion Pneumonectomy: Experience with 47 Cases

Terzi, Alberto; Furlan, G.; Terrini, Alberto; Magnanelli, Giovanni

doi:10.1055/s-2007-1013769

Cited by 21 publications

(14 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[2][3][4][5][6][7][8][9][10][11][12][13][14] In the present study, the actuarial 5-year overall survivals after CP for all malignancy were 49.0%. Accordingly, the good long-term survival of malignancy suggests that CP is one of the treatments of choice for selected patients if complete resection is possible.…”

Section: Discussionmentioning

confidence: 75%

“…To our knowledge, resection of the carina has not been performed in previous studies. [2][3][4][5][6][7][8][9][10][11][12][13][14] Recently, various therapeutic bronchoscopy including laser therapy, electrocautery, brachytherapy, stents, and photodynamic therapy is reported to be useful in retrieving large airway obstruction. 17) Direct intratumoural injection with 5-fluorouracil is reported to reduce the size of tumors in the majority of cases and increase the diameter of the airway lumen.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Results of Completion Pneumonectomy

Haraguchi

Koizumi

Hirata

et al. 2011

Ann Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Purpose: We report our experience with completion pneumonectomy (CP). Methods: We report on operative procedure and morbidity, mortality, and survival rates. Results: CP was performed for malignancy in 12 patients and postoperative complications after the first operation in 4 patients. Intrapericardial dissection of vessels was performed in 14 patients (87.5%). Partial vertebrectomy from the second to the fifth vertebrae was performed in 1 patient. Carinal resection was performed in 2 patients. Morbidity including bronchopleural fistula, pulmonary insufficiency, pyothorax, and pulmonary infarction developed in 6 of the 16 patients (37.5%). Mortality rate was 18.8%. The actuarial 1-, 3-, and 5-year overall survival after CP for all malignancy was 80.8%, 49.0%, and 49.0% respectively. Conclusions: The morbidity and mortality rates are high in CP. Combined resection, especially carinal resection, appears to be contraindicated in CP. CP is one of the treatments of choice, even for malignancy, if complete resection is possible because of the good long-term survival.

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Surgical Results of Completion Pneumonectomy

Haraguchi

Koizumi

Hirata

et al. 2011

Ann Thorac Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…Despite the alleged high complication rate, operative mortality in the majority of series published in the past 15 years is about or slightly above 12% [24][25][26][27][28][29], operative morbidity is under 40% and the bronchopleural fistula rate is ∼10% (table 1). The wide range of the reported mortality rates, in some series reaching 33.3% and operative morbidity up to 62.6% [30], are the consequence of different definitions of complications and inclusion of all types of indications, rather than being strictly procedure-related.…”

mentioning

confidence: 99%

Optimising treatment for post-operative lung cancer recurrence

2016

View full text Add to dashboard Cite

@ERSpublicationsThe second lung resection is a valuable option for post-operative lung cancer recurrence http://ow.ly/U8z3cSurgical treatment offers the best chances for long-term survival in patients with primary nonsmall cell lung cancer (NSCLC). However, long-term survival after surgery remains less than 50%, mostly due to a 30-77% rate of tumour recurrence. Unlike the distant type of recurrence that is treated nonsurgically in the vast majority of patients, local or loco-regional recurrence, which occurs in 4.6-24% of patients after complete resection (∼80% of cases in the first 2 years) [1], raises several concerns related to the optimal therapeutic approach.Unfortunately, literature data are not always helpful in practice. For example, 5-year loco-regional recurrence rates are between 15 and 38.5% [2], and the incidence of local recurrence in early-stage lung cancer of 10-15% [3], or a mean disease-free interval of 14.1-19.8 months, that is similar to distant recurrent disease [4]. Failure to demonstrate the advantage of complete lymphadenectomy over nodal sampling in terms of local recurrence or survival in patients operated for T1-2, N0 or T1-2, N1 disease, makes the clinical approach more complex [5]. Moreover, the impact of intensified follow-up on overall survival or local recurrence detection could not be clearly demonstrated. In ∼50-67% of patients, recurrence will appear before a scheduled control because of the onset of symptoms [6].Finally, switching to seventh edition of the TNM (tumour, node, metastasis) staging system automatically led to the stage migration, reaching 21% in some studies. The only study of the role of computed tomography (CT) in post-operative recurrence detection demonstrated a high negative predictive value of 95%, but a positive predictive value of only 53% (94% sensitivity and 87% specificity) [7]. For positron emission tomography, although it is more sensitive than CT in detecting recurrent tumours (97-100%), variations of the cut-off values for the standardised uptake value (⩾4.5-⩾10) make its clinical application difficult, together with its specificity (62-100%) that is lower than for CT.The role of prognostic factors after surgery is more evidence-based, owing to awareness of the poor 5-year survival of patients in stages IA and IB (73% and 58%, respectively). This also applies to the high recurrence rate in patients with stage I after complete resection (25-50%) [8]. The results of these studies really helped to identify patients who would probably benefit from adjuvant therapy.Among tumour markers, although increased serum concentrations of carcinoembryonic antigen (CEA) are rare (17%), persistently high post-operative CEA levels were found to be a strong indicator of poor prognosis. In 55-70% of patients with CEA values of 5-10 ng·mL , an early recurrence will develop [9].Of the many analysed clinical and pathological prognostic factors, vascular invasion, lymphatic vessel and visceral pleural invasion have been identified as clearly unfavourable in terms of surviv...

show abstract

“…Durch gänzlich fehlende postoperative Komplikationen in dieser Gruppe könnte -bei allerdings geringer Patientenzahl -die fehlende Letalität erklärt werden; Terzi et al beschreibt für diese Gruppe eine deutlich hö-here operative Letalitätsrate von 35% [13].…”

Section: Mortalitätunclassified

“…Terzi et al [13] berichtet über eine 30-TagesLetalität von 57% in der Gruppe von Patienten mit Frühkomplikationen, Al Kattan und Golstraw [1] geben eine 30-Tages-Letalitätsrate von lediglich 2,6% an. Bei uns betrug die Letalität 33,3% und liegt damit deutlich höher als in der Gruppe mit benigner und maligner Erkrankung.…”

Section: Tabelleunclassified

Sekund�re Pneumonektomien

Jungraithmayr

Hasse

Olschewski

et al. 2005

Chirurg

View full text Add to dashboard Cite

Completion pneumonectomy (CP) is widely known to be associated with high morbidity and lethality. However, in certain instances, it offers the only chance for cure. The results of the following CPs (N=86) were investigated: progressive or recurrent benign disease (N=6, group I), recurrence of a malignant tumor (N=41, group II), and complication after lung resection (N=39, group III). Right completion pneumonectomy was carried out in 48 cases and left completion pneumonectomy in 38. The overall 30-day lethality of CP was 20.2%, 0% in group I, 10% n group II, and 33.3% n group III. This lethality was significantly higher on the right side (29.8%) than on the left (7.7%; P=0.014). Differentiation between emergency and urgent indications resulted in 30-day lethalities of 54% and 23%, respectively. This difference is significant (P=0.002). The 30-day lethality for patients with anastomotic or stump insufficiency was 41% (P=0.002). Five-year survival was 26% in the group of patients with malignant disease and 32% in those with complications after lung resection. The results show: the lethality of CP remains high, especially after complications from operating in emergency conditions. However, considering the long-term survival, CP is certainly justified.

show abstract

Completion Pneumonectomy: Experience with 47 Cases

Cited by 21 publications

References 4 publications

Surgical Results of Completion Pneumonectomy

Surgical Results of Completion Pneumonectomy

Optimising treatment for post-operative lung cancer recurrence

Sekund�re Pneumonektomien

Contact Info

Product

Resources

About