Atrial Resection for Lung Cancer: Morbidity, Mortality, and Long-Term Follow-up

Kuehnl, Andreas; Lindner, Michael; Hornung, Hans-Martin; Winter, Hauke; Jauch, Karl-Walter; Hatz, Rudolf A.; Graeb, Christian
September 2010
World Journal of Surgery;Sep2010, Vol. 34 Issue 9, p2233
Academic Journal
The purpose of this study was to examine our results of combined resection of the atrium and non-small-cell lung cancer using a concurrent and continuously updated database. A total of 35 patients underwent extended pulmonary resection with partial resection of the atrium. The main focus of the study was to define subgroups of patients who can potentially benefit from surgery. Pneumonectomy was performed in 31 cases, and the other 4 patients underwent a lesser resection. Postoperative morbidity was 20%, and the mortality rate was 9%. The median intensive care unit stay was 2 days and the hospital stay 13 days. The survival rates were 80% at 1 year, 21% at 3 years, and 16% at 5 years. The median survival of patients with low-grade tumors (G1/2) was 27 months, contrasted by only 15 months’ survival for patients with high-grade tumors ( P = 0.026). Multivariate analysis indicated that completeness of resection had a significant impact on survival ( P = 0.042). Combined resection of lung and atrium is a complex surgical procedure, but it can be performed with fair morbidity and mortality rates, even in patients with an increased number of preoperative risk factors. Patients suffering from low-grade tumors benefit significantly from radical surgery. Future studies must define whether a multimodal therapeutic approach that includes induction therapy can prolong patient survival.


Related Articles

  • Can pneumonectomy for non-small cell lung cancer be avoided? An audit of parenchymal sparing lung surgery. Martin-Ucar, A.E.; Chaudhuri, N.; Edwards, J.G.; Waller, D.A. // European Journal of Cardio-Thoracic Surgery;Apr2002, Vol. 21 Issue 4, p601 

    Background: Lung cancer resection rates are suboptimal in the UK. Pneumonectomy has a higher perioperative mortality risk than lobectomy. To increase resection rates and improve outcomes we have implemented a policy of parenchymal sparing surgery for tumours involving a main stem bronchus....

  • Sleeve resections with unprotected bronchial anastomoses are safe even after neoadjuvant therapy†. Storelli, Erica; Tutic, Michaela; Kestenholz, Peter; Schneiter, Didier; Opitz, Isabelle; Hillinger, Sven; Weder, Walter // European Journal of Cardio-Thoracic Surgery;Jul2012, Vol. 42 Issue 1, p77 

    OBJECTIVES Sleeve resection is the operation of choice in patients with centrally located tumours, in order to avoid a pneumonectomy. Most surgeons protect the bronchial anastomoses with tissue to prevent insufficiencies. The purpose of this study is to report on outcome of unwrapped bronchial...

  • Does induction treatment increase the risk of morbidity and mortality after pneumonectomy? A multicentre case-matched analysis Refai, Majed; Brunelli, Alessandro; Rocco, Gaetano; Ferguson, Mark K.; Fortiparri, Sergio N.; Salati, Michele; La Rocca, Antonello; Kawamukai, Kenji // European Journal of Cardio-Thoracic Surgery;Mar2010, Vol. 37 Issue 3, p535 

    Abstract: Background: The objective of this investigation was to compare postoperative morbidity and early and late mortality in patients after pneumonectomy for non-small-cell lung cancer (NSCLC) with or without induction neo-adjuvant therapy. Methods: This is an observational study performed...

  • Seasonal variation influences outcomes following lung cancer resections LaPar, Damien J.; Nagji, Alykhan S.; Bhamidipati, Castigliano M.; Kozower, Benjamin D.; Lau, Christine L.; Ailawadi, Gorav; Jones, David R. // European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, p83 

    Abstract: Objective: The effect of seasonal variation on postoperative outcomes following lung cancer resections is unknown. We hypothesized that postoperative outcomes following surgical resection for lung cancer within the United States would not be impacted by operative season. Methods: From...

  • The effects of lung resection on physiological motor activity of the oesophagus†. Fiorelli, Alfonso; Vicidomini, Giovanni; Milione, Roberta; Grassi, Roberto; Rotondo, Antonio; Santini, Mario // European Journal of Cardio-Thoracic Surgery;Aug2013, Vol. 44 Issue 2, p250 

    OBJECTIVES To assess the modifications of oesophageal function after major lung resection and whether these modifications are correlated with the extent of resection (pneumonectomy vs others). METHODS In the last 5 years, 40 consecutive surgical patients with lung cancer were prospectively...

  • Pneumonektomie. Schirren, J.; Schirren, M.; Passalacqua, M.; Bölükbas, S. // Der Chirurg;Jun2013, Vol. 84 Issue 6, p474 

    Lung cancer is localized in the upper lobes in more than half of the cases. The risk of tumor infiltration of centrally located structures, such as bronchi and vessels are enhanced due to the anatomic topography. Pneumonectomy competes with sleeve resection for the surgical resection of...

  • Early and long-term results of lung resection for non-small-cell lung cancer in patients with severe ventilatory impairment. Magdeleinat, Pierre; Seguin, Agathe; Alifano, Marco; Boubia, Souheil; Regnard, Jean-François // European Journal of Cardio-Thoracic Surgery;Jun2005, Vol. 27 Issue 6, p1099 

    Abstract: Objective: To study clinical characteristics, surgical treatment modalities, early and long-term outcome of patients with severe ventilatory impairment undergoing lung resection for NSCLC. Methods: We performed a retrospective review of clinical records of all patients with severe...

  • Recent trends in resection rates among non-small cell lung cancer patients in England. Riaz, Sharma P.; Linklater, Karen M.; Page, Richard; Peake, Michael D.; Møller, Henrik; Lüchtenborg, Margreet // Thorax;Sep2012, Vol. 67 Issue 9, p811 

    Background Lung cancer resection rates are low in England, but reports have indicated an increase in recent years. We analysed the recent trends in surgical resection by age, sex, socioeconomic deprivation and surgical procedure in England. Methods Data on 286 217 patients with non-small cell...

  • The risk of pneumonectomy over the age of 70.: A case–control study Leo, Francesco; Scanagatta, Paolo; Baglio, Pierangelo; Radice, Davide; Veronesi, Giulia; Solli, Piergiorgio; Petrella, Francesco; Spaggiari, Lorenzo // European Journal of Cardio-Thoracic Surgery;May2007, Vol. 31 Issue 5, p780 

    Abstract: Objective: A higher mortality has been reported after pneumonectomy over the age of 70. The aim of the study was to quantify the additional risk due to age after standard pneumonectomy for lung cancer by a case–control study. Methods: Our clinical database was reviewed to search...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics