Pneumonectomy for left-sided non-small cell lung cancer: analysis of 111 cases over 10 years

BACKGROUND: Pulmonary resection is the preferred therapeutic option for non-small cell lung cancer (NSCLC). Despite the physiological insult, pneumonectomy (PN) may be unavoidable in patients with early-stage central tumors. This study aimed to analyze the management of early-stage left-sided NSCLC by PN. METHODS: This was a prospective observational study of patients with different stages of NSCLC who underwent left PN over a 10-year period. In-hospital morbidity and mortality and long-term survival were calculated. RESULTS: A total of 111 patients were enrolled (aged 46–80 years). Preoperatively, 53.2% of patients had stage IIIA, 32.4% stage IIB, and 14.4% had stage IIA disease. Postoperatively, the number of patients with stage IIA and IIB decreased while stage IIIA increased. All PNs were radical. The 5- and 10-year survival rates in stage IIA patients were 42.8% and14.2%, respectively, in stage IIB patients were 56.25% and 3.1%, and the 5-year survival in stage IIIA patients was 22. 5%. The overall 1-, 2-, 5-, and 10-year survival rates were 94.6%, 77.47%, 34.23%, and 2.7%, respectively. CONCLUSIONS: The operative mortality, morbidity, and 5-year survival rates of patients with NSCLC after PN matched the international standards. Left PN might be unavoidable for patients with centrally located tumors.