Typical histology and N0 status were important prognostic factors in carcinoid tumors. Parenchyma-sparing procedures must be considered the treatment of choice with systematic lymphadenectomy.

We present a case of chest wall reconstruction after sternochondral resection for sternal metastasis of breast origin. We used three transverse titanium plates to stabilise the chest wall and provide support for a polytetrafluoroethylene dual mesh, which was used to cover the chest wall defect. The pectoralis muscles flaps were approximated in the midline to cover the dual mesh.

The objective of the study was to evaluate the outcome in elderly patients (>75 years) submitted to pneumonectomy for lung cancer. Records of 40 elderly patients, who underwent pneumonectomy at our Institution from 1990 to 2008, were retrospectively reviewed. This group was compared with 289 younger patients submitted to pneumonectomy in the same period. In the older group median age was 77 years (range 75-84 years), 16 were right-side procedures. In the younger group median age was 62 years (range 24-74 years), 114 were right-sided procedures. The overall mortality rate was 7.5% and 6.2% in the older and younger groups, respectively (P=0.75); morbidity rate was 35.1% and 17.7% (P=0.01) and five-year survival rate was 32% and 30%, respectively (P=0.85). Right-sided procedures (P=0.0006) were associated with higher risk of mortality and age over 75 years (P=0.01) with increased risk of morbidity; pathological stage was the only predictor of five-year survival. Pneumonectomy appears to be justified even in patients older than 75 years, because short- and long-term outcomes can be acceptable and comparable with those of younger patients. Advanced age alone does not justify denying curative resection of lung cancer, but right-sided procedures require a careful pre- and postoperative approach.