ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Pneumonectomy after neoadjuvant treatment
Hüseyin Melek1, Mehmet Muharrem Erol1, Ahmet Sami Bayram1, Gamze Çetinkaya1, Türkkan Evrensel2, Süreyya Sarıhan3, Elif Ülker Akyıldız4, Cengiz Gebitekin1
Uludağ Üniversitesi Tıp Fakültesi, Bursa, Türkiye
1Uludağ Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Bursa, Türkiye
2Uludağ Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Anabilim Dalı, Bursa, Türkiye
3Uludağ Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Bursa, Türkiye
4Uludağ Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Bursa, Türkiye
DOI : 10.5606/tgkdc.dergisi.2014.8755
Background: This study was conducted to investigate the effect of pneumonectomy after neoadjuvant therapy on survival, morbidity, and mortality in patients with non small cell carcinoma (NSCLC).

Methods: Files of 130 patients who were performed pneumonectomy in our clinic for NSCLC between November 1995 and August 2012 were retrospectively reviewed. Patients with other malignancies and/or distant metastasis, and who underwent completion pneumonectomy were excluded, and the remaining 116 patients (113 males, 3 females; mean age 57 years; range 31 to 82 years) constituted the study group. Neoadjuvant treatment was administered to 47 patients (group 1) who had advanced stage (T3-4N0-1 or T1-3N2) NSCLC. Pneumonectomy without neoadjuvant treatment was performed in 69 patients with T2-4N0-1 (group 2). Survival, morbidity, and mortality rates were compared between the groups.

Results: Sixty-two patients (53%) underwent left pneumonectomy. The median length of hospital stay was 6.4 days (range 1-33 days). Chemotherapy was administered in 29 patients (62%), and chemoradiotherapy in 18 patients (38%) preoperatively. Left pneumonectomy was performed in 29 patients after neoadjuvant treatment. Complications were detected in 31% of patients (group 1: 28%, group 2: 33%). Ninety-day mortality rate was 4.2% in group 1, and 5.8% in group 2. Five-year-survival rate was 41% and 35% for group 1 and group 2, respectively. Median survival time was 41 months and 40 months for group 1 and group 2, respectively. No statistically significant difference was detected between the two groups in terms of morbidity, mortality, and survival.

Conclusion: This study showed that pneumonectomy after neoadjuvant treatment may be safely administered in patients with locally advanced NSCLC with acceptable morbidity, mortality, and survival rates.

Keywords : Morbidity; mortality; neoadjuvant therapy; pneumonectomy; survival
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