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Vol. 42. Issue 4.
Pages 160-164 (April 2006)
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Vol. 42. Issue 4.
Pages 160-164 (April 2006)
Original Articles
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Sleeve Lobectomy Compared to Pneumonectomy for the Treatment of N0-N1 Non-Small Cell Lung Cancer
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M.F. Jiménez
Corresponding author
mfjl@usal.es

Correspondence. Dr. M.F. Jiménez. Sección de Cirugía Torácica. Hospital Universitario. P.o de San Vicente, 58–182. 37007 Salamanca. España
, G. Varela, N. Novoa, J.L. Aranda
Sectión de Cirugía Torácia, Hospital Universitario, Salamanca, Spain
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Objective

To compare survival, morbidity, and mortality rates for a series of patients who underwent either bronchoplastic sleeve lobectomy or pneumonectomy to treat non-small cell lung cancer (NSCLC).

Patients and method

We reviewed the clinical records for patients who underwent sleeve lobectomy or pneumonectomy for NSCLC from January 1994 through December 2003.

Results

From January 1994 through December 2003, 35 sleeve lobectomies and 220 pneumonectomies were performed at our department on patients with NSCLC. The perioperative mortality rate was 2.8% for the lobectomy group and 9.1% for the pneumonectomy group. The mean survival time for the pneumonectomy group was 45 months (95% confidence interval [CI], 37–53), with a 5-year survival rate of 32% (SE, 5.1%). The mean survival time for the sleeve lobectomy group was 72 months (95% CI, 56–87) (P≤.0041), with a 5-year survival rate of 56% (SE, 9.6%). If we stratify the groups according to node involvement, patients classified as N0-N1 had a mean survival time of 52 months (95% CI, 43–61), with a 5-year survival rate of 39% (SE, 6.2%) for the pneumonectomy group. The mean survival time for patients undergoing sleeve lobectomy was 75 months (95% CI, 59–92) (P≤.018), with a 5-year survival rate of 60% (SE, 10.4%). Survival for patients with N2 disease was similar to that of patients with N0-N1 disease.

Conclusion

For patients with N0-N1 non-small cell lung cancer, sleeve lobectomy offers better survival than pneumonectomy.

Key words:
Sleeve lobectomy
Lung cancer
Sleeve resection
Survival
Pneumonectomy
Objetivo

Comparar la supervivencia, morbilidad y mortalidad de una serie de pacientes operados por cáncer de pulmón no microcítico (CPNM) mediante lobectomía broncoplástica o neumonectomía.

Pacientes y método

Hemos revisado los datos de pacientes a quienes se realizó una lobectomía broncoplástica o una neumonectomía por CPNM entre enero de 1994 y diciembre de 2003.

Resultados

Entre enero de 1994 y diciembre de 2003 se realizaron en nuestra unidad 35 lobectomías con broncoplastia y 220 neumonectomías en pacientes con CPNM. La mortalidad perioperatoria fue del 2,8% en el grupo de las lobectomías y del 9,1% para las neumonectomías. La media de supervivencia de las neumonectomías fue de 45 meses (intervalo de confianza [IC] del 95%, 37–53) y la supervivencia a los 5 años del 32% (error estándar [EE]: 5,1). En el grupo de lobectomías broncoplásticas la media de supervivencia fue de 72 meses (IC del 95%, 56–87) (p ≤ 0,0041) y la supervivencia a los 5 años del 56% (EE: 9,6). Si estratificamos los grupos según la afectación ganglionar, entre los pacientes clasificados como N0-N1 la media de supervivencia fue de 52 meses (IC del 95%, 43–61) y la supervivencia a los 5 años del 39% (EE: 6,2) en las neumonectomías. Los pacientes con lobectomía broncoplástica presentaron una media de supervivencia de 75 meses (IC del 95%, 59–92) (p ≤ 0,018) y la supervivencia a los 5 años del 60% (EE: 10,4). La supervivencia no fue diferente en caso de enfermedad N2.

Conclusión

La lobectomía broncoplástica ofrece mejor supervivencia que la neumonectomía en pacientes con CPNM con afectación N0-N1.

Palabras clave:
Lobectomia broncoplástica
Cáncer de pulmón
Resecciones broncoplásticas
Supervivencia
Neunonectomía
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Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
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