Pulmonary Resection for Second Lung Cancer After Pneumonectomy: A Population-Based Study

Ayub, Adil; Rehmani, Sadiq; Al-Ayoubi, Adnan M.; Raad, Wissam; Flores, Raja M.; Bhora, Faiz Y.

doi:10.1016/j.athoracsur.2017.04.043

Cited by 20 publications

(56 citation statements)

References 16 publications

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“…It was found that the survival rate was better for metachronous than for metastatic cancer (12). In a wider cohort of patients, Ayub et al (13) found that sublobar resection had higher median overall survival than did those who underwent lobectomy (42 vs. 18 months); median survival after resection for metachronous tumors was higher than after resection for metastatic cancers (40 vs. 28 months). This study lacks information about patients' functional status, cardiopulmonary reserves, comorbidities, surgical approach (open vs. minimally invasive, type of thoracotomy) and reported at not negligible 1-and 3-month mortality (respectively, 11.1% and 12.7%).…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic wedge resection in single-lung patients

Zampieri¹,

Marulli²,

Comacchio³

et al. 2018

J. Thorac. Dis.

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Thoracoscopic surgery represents a feasible surgical option in selected patients after contralateral pneumonectomy, with careful preoperative assessment and using short apnea windows in good collaboration with anesthesiologists. Histological definition, made possible by the surgical-procedure, gives patients the possibility to eventually undergo further targeted therapies. Randomized prospective trials are necessary to assess the best management of peripheral small lung nodules in single-lung patients, in particular to define which patients can benefit from a surgical approach.

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Section: Discussionmentioning

confidence: 99%

Thoracoscopic wedge resection in single-lung patients

Zampieri¹,

Marulli²,

Comacchio³

et al. 2018

J. Thorac. Dis.

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“…The standard surgical treatment for primary lung cancer is lobectomy; however, 3%-7% of patients with lung cancer require pneumonectomy. 1,2 Reports show that the risk of tumor recurrence after complete resection of lung cancer is 2%-5% per year, 3,4 depending on the stage. Moreover, metachronous lung cancer occurs in 1%-5% of cases of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

“…8 Pneumonectomy has been reported to increase the total vascular resistance of the pulmonary circulation and may increase the right ventricular load 9 ; therefore, a history of pneumonectomy is considered a relative contraindication for further pulmonary resection. 2 Careful intraoperative respiratory management is essential during contralateral pulmonary resection in postpneumonectomy patients. During normal respiratory management, the operative field is suboptimal due to ventilation of the operative side 10 ; therefore, thoracotomy is performed in most patients.…”

Section: Introductionmentioning

confidence: 99%

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

et al. 2020

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Background: Pulmonary resection is occasionally performed in postpneumonectomy patients with contralateral lung lesions, such as metachronous or metastatic lung cancer. Careful intraoperative respiratory management is essential in such patients. This study evaluated the respiratory management of postpneumonectomy patients who underwent contralateral pulmonary resection with selective bronchial blockade of the lobe or segment to be resected. Methods: We retrospectively analyzed the surgical findings and safety of surgery in six patients who underwent contralateral pulmonary resection with selective bronchial blockade after pneumonectomy for non-small cell lung cancer (NSCLC). Results: The percutaneous oxygen saturation did not decrease in any of the patients during bronchial blockade under high oxygen concentration. The median blockade time was 57.5 minutes. The operative field was tolerable secured under conditions of partial lung collapse, and partial pulmonary resection was performed as planned. Postoperatively, one patient developed acute respiratory distress syndrome due to acute exacerbation of interstitial pneumonia; however, no patients died within one month postoperatively. Two patients underwent pulmonary resection in order to obtain adequate tissue specimens to evaluate the biomarkers of multiple lung metastases. On histopathology, one patient tested positive for anaplastic lymphoma kinase (ALK) and was subsequently administered an ALK inhibitor, which prolonged survival. Conclusions: In all patients, intraoperative respiratory condition under partial lung collapse remained stable, and all partial pulmonary resections were safely performed. However, surgical indications should be carefully reviewed preoperatively in patients with interstitial pneumonia.

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“…With the advancement in early detection technology of lung cancer and the close postoperative follow-up of lung cancer patients, the detection rate of second primary lung cancer (SPLC) has been growing. The e cacy and safety of surgical treatment for second primary non-small cell lung cancer (SP-NSCLC) patients have also been demonstrated in several studies [1][2][3][4][5][6][7]. For the patients with resectable earlystage NSCLC, lobectomy remains the accepted standard surgical procedure [8].…”

Section: Introductionmentioning

confidence: 99%

Survival After Wedge Resection Versus Lobectomy for Stage Ia Second Primary NSCLC with Previous Lung Cancer-Directed Surgery

Song

et al. 2020

Preprint

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Background: The surgical procedure for early-stage second primary non-small cell lung cancer (SP-NSCLC) remains controversial, especially for patients with previous lung cancer-directed surgery. This study aims to compare the survival after wedge resection and lobectomy for these patients. Methods: Stage IA SP-NSCLC patients with clear information were searched from the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazard model, competing risk model and Kaplan-Meier survival curve were used to describe the survival difference between wedge resection and lobectomy. A 1:1 propensity score matching (PSM) method was also performed to reduce the potential impact of confounding factors between the two groups. Results: Of the 320 eligible stage IA SP-NSCLC patients included in this study, 238 (74.4%) patients underwent wedge resection and 82 (25.6%) patients received lobectomy. The 5-year overall survival (OS) was 61.3% with wedge resection and was 66.1% with lobectomy. Both before and after PSM, wedge resection showed similar survival rate and lung cancer specific mortality as lobectomy in the entire cohort. Additionally, in all subgroup analyses, wedge resection demonstrated equivalent survival to lobectomy. However, in the female, sub-lobectomy for FPLC and interval ≤ 24 months subgroups, wedge resection had a higher lung cancer specific mortality than lobectomy (fine-gray test, all p < 0.05). Conclusion: In conclusion, wedge resection was comparable to lobectomy in OS with all relevant parameters. In a few cases, lung cancer specific mortality in wedge resection group was higher than that in lobectomy group.

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Pulmonary Resection for Second Lung Cancer After Pneumonectomy: A Population-Based Study

Cited by 20 publications

References 16 publications

Thoracoscopic wedge resection in single-lung patients

Thoracoscopic wedge resection in single-lung patients

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

Survival After Wedge Resection Versus Lobectomy for Stage Ia Second Primary NSCLC with Previous Lung Cancer-Directed Surgery

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Pulmonary Resection for Second Lung Cancer After Pneumonectomy: A Population-Based Study

Cited by 20 publications

References 16 publications

Thoracoscopic wedge resection in single-lung patients

Thoracoscopic wedge resection in single-lung patients

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

Survival After Wedge Resection Versus Lobectomy for Stage Ia Second Primary&nbsp;NSCLC with Previous Lung Cancer-Directed Surgery

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Survival After Wedge Resection Versus Lobectomy for Stage Ia Second Primary NSCLC with Previous Lung Cancer-Directed Surgery