PMID- 18280612
OWN - NLM
STAT- MEDLINE
DCOM- 20081118
LR  - 20080728
IS  - 0169-5002 (Print)
IS  - 0169-5002 (Linking)
VI  - 61
IP  - 2
DP  - 2008 Aug
TI  - Tracheal sleeve pneumonectomy for non small cell lung cancer (NSCLC): short and 
      long-term results in a single institution.
PG  - 202-8
LID - 10.1016/j.lungcan.2007.12.015 [doi]
AB  - OBJECTIVE: Bronchogenic carcinoma involving the carina or tracheobronchial angle 
      still presents a challenge due to specific problems related to surgical technique 
      and airway management. We reviewed our experience in carinal resection in terms 
      of mortality, morbidity, and long-term survival. METHODS: Between 1982 and 2005, 
      49 patients underwent carinal resection: a right tracheal sleeve pneumonectomy 
      was performed in 48 patients and a left tracheal sleeve pneumonectomy in 1 
      patient. Induction therapy was administered to 19 (39.6%) patients. In all cases, 
      the anastomosis was performed with aid of high-frequency jet ventilation. 
      RESULTS: Fourteen patients experienced perioperative complications (overall 
      morbidity 28.6%), including 3 who died, for an overall mortality rate of 6.1%. 
      Late empyema occurred in 5 (10.8%) patients. Histology was squamous cell 
      carcinoma in 38 (77.6%) cases, adenocarcinoma in 10 (20.4%), and large-cell 
      carcinoma in 1 (2%). The overall 5- and 10-year survival rates were 27.5 and 
      12.8%, respectively. Patients without nodal involvement had a significantly 
      better prognosis than N1 and N2 patients (5-year survival: 56, 17, and 0%, 
      respectively; p=0.002), as did patients with squamous histology compared to 
      adenocarcinoma (5-year survival 29.5 and 11%, respectively; p=0.05). Multivariate 
      analysis showed that nodal status was the only independent prognostic factor 
      (p=0.00007). CONCLUSIONS: Tracheal sleeve pneumonectomy for bronchogenic 
      carcinoma can be accomplished with acceptable mortality and morbidity, providing 
      good long-term results. Nodal involvement seems to be an exclusion criterion for 
      surgery, as it has a poor prognosis. Meticulous anesthetic management and 
      surgical technique guarantee a better postoperative outcome.
FAU - Rea, Federico
AU  - Rea F
AD  - Department of Cardiologic, Thoracic and Vascular Sciences, Division of Thoracic 
      Surgery, University of Padua, Via Giustiniani, 2, 35100 Padua, Italy. 
      federico.rea@unipd.it
FAU - Marulli, Giuseppe
AU  - Marulli G
FAU - Schiavon, Marco
AU  - Schiavon M
FAU - Zuin, Andrea
AU  - Zuin A
FAU - Hamad, Abdel-Mohsen
AU  - Hamad AM
FAU - Feltracco, Paolo
AU  - Feltracco P
FAU - Sartori, Francesco
AU  - Sartori F
LA  - eng
PT  - Journal Article
DEP - 20080215
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arrhythmias, Cardiac/*mortality
MH  - Carcinoma, Non-Small-Cell Lung/diagnosis/mortality/pathology/*surgery
MH  - Female
MH  - Humans
MH  - Italy
MH  - Lung Neoplasms/diagnosis/mortality/pathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Pneumonectomy/mortality/statistics & numerical data
MH  - Postoperative Complications/*mortality
MH  - Preoperative Care
MH  - Risk Factors
MH  - Survival Analysis
MH  - Time Factors
MH  - Trachea/pathology/*surgery
EDAT- 2008/02/19 09:00
MHDA- 2008/11/19 09:00
CRDT- 2008/02/19 09:00
PHST- 2007/08/20 00:00 [received]
PHST- 2007/10/19 00:00 [revised]
PHST- 2007/12/18 00:00 [accepted]
PHST- 2008/02/19 09:00 [pubmed]
PHST- 2008/11/19 09:00 [medline]
PHST- 2008/02/19 09:00 [entrez]
AID - S0169-5002(07)00732-5 [pii]
AID - 10.1016/j.lungcan.2007.12.015 [doi]
PST - ppublish
SO  - Lung Cancer. 2008 Aug;61(2):202-8. doi: 10.1016/j.lungcan.2007.12.015. Epub 2008 
      Feb 15.