Outcome of pneumonectomy for primary non-small cell lung cancer - A ten-year experience

Between 1982 and 1992, 105 patients with non-small cell lung cancer underwent pneumonectomy and mediastinal node dissection. Thirteen patients (12%) were categorized as pathological stage I, 18 (17%) were categorized as pathological stage II, 63 (60%) were categorized as pathological stage IIIa, and 11 (11%) were categorized as pathological stage IIIb. The overall actuarial 3-year survival rate was 27%. Postpneumonectomy complications occurred in 20 patients. Operative mortality occurred only in 8 pathological stage IIIa male patients (7.6%). No significant differences in operative mortality were noted for the following criteria: age, sex, side of resection, pathological stage, histologic classification, preoperative forced expiratory volume in 1 second (FEV1) of 2.0 L or less, and predicted postoperative FEV1 of 1.0 L or less. Of the surviving 97 patients, 3 patients were lost during follow-up, 13 patients (13.8%) died due to pneumonia and/or respiratory failure, and 40 patients (42.6%) died due to distant metastases, with bone as the most common metastatic site, during the mean follow-up time of 39 months. Pathological stage I and stage II patients showed actuarial 3-year survival rates, of 60.0% and 31.3% respectively. The survival rates of stage I and stage II patients were higher than for stage IIIa patients.