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Open Access 01-12-2014 | Research

Standard versus extended pneumonectomy for lung cancer: what really matters?

Authors: Dragan Subotic, Milan Savic, Nikola Atanasijadis, Milan Gajic, Jelena Stojsic, Marko Popovic, Vladimir Milenkovic, Zeljko Garabinovic

Published in: World Journal of Surgical Oncology | Issue 1/2014

Abstract

Background

It is still not clear whether an intrapericardial pneumonectomy indicates a more advanced stage of the disease compared to a standard pneumonectomy.

Methods

This was a retrospective study of 164 patients who underwent a pneumonectomy for lung cancer. The first group consisted of 82 patients who had a standard pneumonectomy and the second group was 38 patients who had a intrapericardial pneumonectomy, for both groups in the latest 5-year period. The third group was 44 patients with had a sleeve pneumonectomy in the latest 10-year period. The groups were compared in relation to the overall and stage-related survival, influence of T and N factors, operative morbidity and mortality. The statistics used were Kaplan–Meier, U-test, t-test, χ² test.

Results

There was no statistically significant difference in stage distribution between standard and intrapericardial pneumonectomies; stages I, II, IIIA and IIIB occurred for 10.9% vs 2.6%, 30.5% vs 26.3%, 46.4% vs 65.8% and 12.2% vs 5.3% of patients, respectively. For patients who had a sleeve pneumonectomy, stage IIIA was significantly more frequent. Although the overall survival (63.5% vs 57.6%) and stage-related 5-year survival were better in the first compared to the second group, especially for stage IIIA (58.6% vs 42.6%), these differences were not statistically significant. There were no significant differences in operative morbidity and mortality between groups 1 and 2, but both were significantly higher in the third group (35.7% and 15.9%).

Conclusions

An intrapericardial pneumonectomy does not always indicate a more advanced stage of the disease. The need for an intrapericardial pneumonectomy, either established preoperatively or during the operation, as a single factor, even for marginal surgical candidates, is not strong enough to reject these patients for surgery.

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Title: Standard versus extended pneumonectomy for lung cancer: what really matters?
Authors: Dragan Subotic
Milan Savic
Nikola Atanasijadis
Milan Gajic
Jelena Stojsic
Marko Popovic
Vladimir Milenkovic
Zeljko Garabinovic
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-12-248

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Standard versus extended pneumonectomy for lung cancer: what really matters?

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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