Completion pneumonectomy in cancer patients: experience with 55 cases

Guggino, Gianluca; Doddoli, Christophe; Barlési, Fabrice; Acri, Pablo; Chetaille, Bruno; Thomas, Philippe; Giudicelli, R; Fuentès, P.

doi:10.1016/j.ejcts.2003.12.002

Cited by 59 publications

(48 citation statements)

References 18 publications

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“…[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%

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Surgical Results of Completion Pneumonectomy

Haraguchi

Koizumi

Hirata

et al. 2011

Ann Thorac Cardiovasc Surg

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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.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Surgical Results of Completion Pneumonectomy

Haraguchi

Koizumi

Hirata

et al. 2011

Ann Thorac Cardiovasc Surg

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“…[2][3][4][5][6][9][10][11][12][13][14][15][16][17] The overall 30-day mortality and late mortality rates of the current series were 14.8% and 22%, respectively, and the non-complication group had a much higher rate of mortality than the other group, although this was not statistically significant.…”

Section: Discussionmentioning

confidence: 96%

“…McGovern et al [2] 113 12.4 9.4 27.6 38.1 11.7 Van Schil et al [15] 19 15.8 10.5 Gregoire et al [3] [16] 66 7.6 53 7.6 Terzi et al [17] 59 3.4 3.4 30 Miller et al [14] 115 20.9 17.6 26.3 62.6 7 Guggino et al [13] 55…”

Section: Study No Overall Mortality (%) Malignant (%) Benign (%) Overmentioning

confidence: 99%

Does the indication for completion pneumonectomy affect outcome?

Akin¹,

Olcmen²,

İşgörücü³

et al. 2011

Turkish J Thorac Cardiovasc Surg

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Amaç: Bu çalışmada 20 yıllık deneyimimiz gözden geçi-rildi ve tamamlayıcı pnömonektominin morbidite ve mortalite oranlarını etkileyen faktörler araştırıldı. Ça lış ma pla nı: Haziran 1987 ile Haziran 2008 tarihleri arasında 54 hastaya kliniğimizde tamamlayıcı pnömonek-tomi yapıldı. Hastalar tamamlayıcı pnömonektomi endikasyonları açısından önceki ameliyatın komplikasyonu ya da kalan akciğerde yeni bir hastalık gelişimi nedeni ile iki gruba ayrıldı. Bul gu lar: Genel komplikasyon oranı %42.5 idi ve bu morbidite komplikasyon grubunda anlamlı ölçüde daha yüksek idi (p= 0.04). Genel mortalite oranı %22 idi ve yaş mortalite için tek etkili faktör olarak bulundu (p= 0.03). So nuç: Yirmi yıllık deneyimimiz ve literatürdeki diğer bilgiler ışığında, tamamlayıcı pnömonektomide akıbeti kötü yönde etkileyen faktörün işlemin kendisinden ziyade, girişimin önceki ameliyatın komplikasyonu nedeni ile yapılması olduğu görüldü.Anah tar söz cük ler: Tamamlayıcı pnömonektomi; morbidite; mortalite. Background:In this report, we reviewed our 20-year experience and investigated the factors affecting morbidity and mortality of completion pneumonectomy. Methods: Fifty-four patients underwent completion pneumonectomy in our clinic between June 1987 and June 2008. Patients were divided into two groups according to their indications for completion pneumonectomy, either for a complication of the previous operation or a new disease in the remaining lung. Results: The overall complication rate was 42.5%, and this morbidity was significantly higher in the complication group (p=0.04). The overall mortality rate was 22%, and age was found as the only factor affecting mortality (p= 0.03). Conclusion:The experience that we had over 20 years and the other information from the literature pointed out that the complications in the first operations adversely affected the outcome rather than the procedure itself in completion pneumonectomy.

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“…Perioperative blood loss is usually more significant than during first-time surgery. In three recent series, the perioperative mortality of completion pneumonectomy was 10-16% at large teaching institutions and postoperative complications occurred in 41-55% of patients [173][174][175]. Nonetheless, redo surgery can be justified by the good long-term results of completion pneumonectomy: 37-46% survival at 5-years [173][174][175].…”

Section: Reoperations For Cancer and Completion Pneumonectomymentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

Eur Respir Rev

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Completion pneumonectomy in cancer patients: experience with 55 cases

Cited by 59 publications

References 18 publications

Surgical Results of Completion Pneumonectomy

Surgical Results of Completion Pneumonectomy

Does the indication for completion pneumonectomy affect outcome?

Surgery for nonsmall cell lung cancer

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