Sleeve Lobectomy Compared to Pneumonectomy for the Treatment of N0-N1 Non-Small Cell Lung Cancer

Jiménez, M.F.; Varela, G.; Novoa, N.; Aranda, J.L.

doi:10.1016/S1579-2129(06)60436-9

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 42. Issue 4.

Pages 160-164 (April 2006)

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Pages 160-164 (April 2006)

Original Articles

DOI: 10.1016/S1579-2129(06)60436-9

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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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