The analysis of prognosis factor in patients with non-small cell lung cancer receiving pneumonectomy

Abstract

Background: Pneumonectomy is a procedure that possesses several side effects, but is sometimes necessary in the management of non-small cell lung cancer (NSCLC). The benefits of pneumonectomy have yet to be clearly outlined. Methods: Data of 100 cases were extracted from the medical records of patients that underwent a pneumonectomy for NSCLC from January 2007 to December 2016. Primary outcomes were 5-year overall survival (OS) and 30-day mortality. Statistical comparisons were performed using the Chi-Square test.Kaplan-Meier curves were utilized to evaluate the 5-year OS which were compared using the log-rank test.Multivariable analysis of survival data was done using risk proportional model. Results:The 5-year OS of NSCLC after pneumonectomy is 32.3%. Squamous cell carcinomas had a better prognosis than adenocarcinomas (P=0.039). Patients with higher N stage had a worse prognosis.Among patients undergoing pneumonectomy with N2 lymphatic metastasis, those who also underwent neoadjuvant therapy achieved a better 5-year OS (P=0.042). The 30-day mortality was 4.0%. Conclusions: Pneumonectomy sometimes is inevitable and necessary in certain subtypes of NSCLC with acceptable perioperative mortality and long-term survival. For patients with NSCLC undergoing pneumonectomy, pathological diagnosis and nodal stage were independent predictors of OS. When pneumonectomy was done in patients with NSCLC and N2 lymphatic metastasis, a better long-term OS could be achieved amongst patients receiving neoadjuvant therapy compared to those without neoadjuvant therapy.

Machine learning and BP neural network revealed abnormal B cell infiltration predicts the survival of lung cancer patients

“…The 5-year survival rate of advanced NSCLC is 5-15% ( 15 ). As immunotherapy has made significant breakthroughs in NSCLC, the human immune system recruits and activates T cells to recognize and eliminate cancer cells ( 16 ).…”

Clinical characteristics and survival outcomes of patients with pneumonectomies: A population-based study

“…Nonetheless, PNs have relatively high morbidity and mortality (5.0%–10.0%) in the treatment of lung cancer ( 16 ). The operation is traumatic and the risk of postoperative complications including cardiac arrhythmias, cardiac failure, pulmonary infection, bronchopleural fistula, and acute respiratory distress syndrome (ARDS) is high ( 6 , 7 , 17 , 18 ). Complication rates are generally higher after a right PN and these may affect long-term survival outcomes.…”

“…However, a PN remains challenging with high complications, such as bronchopleural fistula, progressive pulmonary hypertension, respiratory failure, etc. ( 6 , 7 ). Depending on the surgeon's experience, and the histological and anatomical characteristics of the lung and tumor, survival may be better for a left PN than the right ( 8 ).…”

A Nomogram to Predict Long-Term Survival Outcomes of Patients Who Undergo Pneumonectomy for Non-small Cell Lung Cancer With Stage I-IIIB

“…Similarly, in 2019, Yang et al reported that right-sided or left-sided pneumonectomy after induction chemotherapy was not beneficial for long-term survival ( 23 ). Wang et al also analyzed the data of 100 cases with pneumonectomy and found that the right- or left-side resection didn't give a long-term survival benefit for those patients ( 24 ). However, according to the study conducted by Dhanasopon et al, right pneumonectomy patients had worse prognosis compared to left pneumonectomy patients ( 25 ).…”