BACKGROUND: The aim of this study was to determine the risk of overall death in long-term survivors (> 5 years) after pneumonectomy for non-small cell lung cancer (NSCLC), and to establish the optimal follow-up strategy for these patients. METHODS: We analyzed a single-center experience with 94 long-term survivors who underwent pneumonectomy (group A) for NSCLC between January 1992 and December 2000. Prospective tumor registry data were compared with data for 147 long-term survivors who underwent lobectomy (group B) during the same period. RESULTS: Clinical characteristics at the time of operation differed between the two groups with more squamous histology, larger tumor size, and more advanced stage in group A compared with group B. During follow-up, late lung cancer relapses were rare in both groups (2.1% vs 1.4%), and second primary malignancies were less frequent in group A (2.1% vs 9.5%, p = 0.032). The overall 10-year survival rate was lower in group A than in group B (67.3% vs 82.8%); however, there was no significant difference in lung cancer-specific survival (93.5% vs 95.1%). Intercurrent disease was the leading cause of death in group A (14 patients, 14.9%), most commonly respiratory failure resulting from community-acquired pneumonia. CONCLUSION: Late cancer relapse or second primary malignancies were rare in long-term survivors after pneumonectomy, but the overall mortality remained high as a result of intercurrent diseases. Continued surveillance should focus on prevention, early detection and aggressive management of intercurrent disease during follow-up care of these patients.
BACKGROUND: The aim of this study was to determine the risk of overall death in long-term survivors (> 5 years) after pneumonectomy for non-small cell lung cancer (NSCLC), and to establish the optimal follow-up strategy for these patients. METHODS: We analyzed a single-center experience with 94 long-term survivors who underwent pneumonectomy (group A) for NSCLC between January 1992 and December 2000. Prospective tumor registry data were compared with data for 147 long-term survivors who underwent lobectomy (group B) during the same period. RESULTS: Clinical characteristics at the time of operation differed between the two groups with more squamous histology, larger tumor size, and more advanced stage in group A compared with group B. During follow-up, late lung cancer relapses were rare in both groups (2.1% vs 1.4%), and second primary malignancies were less frequent in group A (2.1% vs 9.5%, p = 0.032). The overall 10-year survival rate was lower in group A than in group B (67.3% vs 82.8%); however, there was no significant difference in lung cancer-specific survival (93.5% vs 95.1%). Intercurrent disease was the leading cause of death in group A (14 patients, 14.9%), most commonly respiratory failure resulting from community-acquired pneumonia. CONCLUSION: Late cancer relapse or second primary malignancies were rare in long-term survivors after pneumonectomy, but the overall mortality remained high as a result of intercurrent diseases. Continued surveillance should focus on prevention, early detection and aggressive management of intercurrent disease during follow-up care of these patients.
Authors: Charles A Butts; Keyue Ding; Lesley Seymour; Philip Twumasi-Ankrah; Barbara Graham; David Gandara; David H Johnson; Kenneth A Kesler; Mark Green; Mark Vincent; Yvon Cormier; Glenwood Goss; Brian Findlay; Michael Johnston; Ming-Sound Tsao; Frances A Shepherd Journal: J Clin Oncol Date: 2009-11-23 Impact factor: 44.544
Authors: Piotr J Skrzypczak; Magdalena Roszak; Mariusz Kasprzyk; Anna Kopczyńska; Piotr Gabryel; Wojciech Dyszkiewicz Journal: Kardiochir Torakochirurgia Pol Date: 2019-04-04
Authors: Gregory D Jones; Raul Caso; Kay See Tan; Joseph Dycoco; Prasad S Adusumilli; Manjit S Bains; Robert J Downey; James Huang; James M Isbell; Daniela Molena; Bernard J Park; Gaetano Rocco; Valerie W Rusch; Smita Sihag; David R Jones; Matthew J Bott Journal: Ann Surg Date: 2022-04-01 Impact factor: 13.787