Elective Pneumonectomy for Non-Small Cell Lung Cancer: Factors Affecting Early Operative Mortality and Morbidity

Abstract

Among the pneumonectomies performed for NSCLC, the causes of postoperative morbidity were multifactorial, however, multivariate analysis did not show any significant factor affecting the mortality, related to this procedure.

Risk factors for early mortality and morbidity after pneumonectomy

“…The mortality rate for SCC is higher than for other types of cancer. [7,16] However, Jazieh et al [17] found no relationship between cell type and survival in their study that involved 551 cases. In our study, increased mortality rates were statistically significant for adenocarcinoma (p= 0.048).…”

“…[3] Bernard et al [5] suggested that complications occur at an overall rate of 43%, with 38% of these being cardiopulmonary in nature. The cardiopulmonary complication rate was 68.8% in the study by Guggino et al [6] that was comprised of 55 cases, and Karamustafaoğlu et al [7] identified a pulmonary complication rate of 28%, and a cardiac complication rate of 12% in their study.…”

“…The development of BPFs was higher in patients who underwent a right pneumonectomy. [3,9,16] Despite this, Licker et al [8] and Bernard et al [15] found an insignificant correlation between pneumonectomy side and BPFs, but Karamustafaoğlu [7] determined that the development of BPFs was statistically significant for 14% of the patients in their study who underwent a right pneumonectomy and 5% who had a left pneumonectomy. Furthermore, Stolz et al [10] found that the risk factors that affected the development of BPFs were male gender and COPD, and Guggino et al [6] determined that the average BPF ratio (12.7%) increased with neoadjuvant chemotherapy (23.8%).…”

“…In another study by Stolz et al, [10] there was a correlation between an increase in 30-day mortality and CAD and respiratory failure; however, no statistically significant relationship existed between smoking status or COPD and morbidity and mortality. Karamustafaoğlu et al [7] identified the risk factors for increasing cardiopulmonary morbidity rate as being age (≥60) and BPFs. They also reported that right pneumonectomies had a statistically significant effect on cardiopulmonary morbidity and mortality, but tumor grade did not play a significant role.…”

Native Lung Complications in Single-lung Transplant Recipients and the Role of Pneumonectomy

“…6 Other groups have reported similar morbidity and mortality rates. 7 Completion pneumonectomy has been associated with even higher mortality rates. 8,9 Fitton and colleagues examined outcomes at their institution in lung transplant recipients undergoing lobectomy or wedge resection, concluding that resections could be safely performed after lung transplantation.…”