Completion pneumonectomy*A retrospective analysis of indications and results

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Abstract
Between 1970 and 1993, 446 patients underwent pneumonectomy. Completionpneumonectomy was performed in 37 patients (8.3%): 34 men and 3 women, witha mean age of 61 years (range 20-78 years). Indications were benign diseasein 4 patients and carcinoma in 33. Of the latter, 21 patients underwentresection for metachronous lung cancer, 6 for recurrent lung cancer, 4 forprevious incomplete resection, 1 for primary lung cancer after previousresection for benign disease and 1 patient after previous segmentectomy formetastasis. The mean interval between first operation and completionpneumonectomy was 41 months (range 1-187 months) for the whole group, 30months for benign disease and 42 months for carcinoma. The overalloperative mortality was 6/37 (16.2%); 1/4 patients with benign disease and5/33 (15.2%) patients with carcinoma. Nine patients (29%) had one or moremajor non-fatal complication. Actuarial 3- and 5-year survival rates were41.0% and 24.5% for the entire group, 75% at both times for patients withbenign disease, 36.4% and 18.3% for all patients with carcinoma at the timeof completion pneumonectomy and 24.3% and 14.5% for patients withmetachronous or recurrent lung cancer. For 15 patients with stage I or IImetachronous lung cancer, the 3- and 5-year survival rates were 33.9% and16.9%. All six patients with stage III metachronous cancer died within 18months. In conclusion, completion pneumonectomy carries a high operativemortality and morbidity. Long-term survival is negatively influenced bystage III lung cancer.

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