LONG-TERM OUTCOME AFTER PNEUMONECTOMY FOR NONSMALL CELL LUNG-CANCER

Long-term survivors (5 or more years) of pneumonectomy for nonsmall ce ll lung cancer are at risk for late death from cancer recurrence, seco nd primary malignancies, and cardiopulmonary insufficiency related to the adverse physiological effects of pneumonectomy. A retrospective st udy of pneumonectomy patients was done to quantify the risks of late d eath from these causes. Of 246 patients treated for nonsmall cell lung cancer by pneumonectomy, medical records of 49 who survived 5 or more years were reviewed. Follow-up for the 49 long-term survivors ranged from 60 to 240 months, with a mean of 113 months. Twenty-five (51%) of the long-term survivors were alive at the time of the study. Twenty-f our (49%) had died. Causes of death included late lung cancer recurren ce (6 patients), second primary malignancies (7 patients), cardiopulmo nary insufficiency (4 patients), and miscellaneous causes unrelated to cancer and its treatment (7 patients). Long-term survival after pneum onectomy for nonsmall cell lung cancer occurs in 20% of patients. Late lung cancer recurrence and second primary malignancies are important causes of death in these patients. Late cardiopulmonary insufficiency related to adverse physiological consequences of pneumonectomy is unco mmon. Long-term follow-up is recommended after pneumonectomy for nonsm all cell lung cancer. (C) 1996 Wiley-Liss, Inc.