COMPLETION PNEUMONECTOMY - A RETROSPECTIVE ANALYSIS OF INDICATIONS AND RESULTS

Between 1970 and 1993, 446 patients underwent pneumonectomy. Completio n pneumonectomy was performed in 37 patients (8.3): 34 men and 3 women , with a mean age of 61 years (range 20-78 years). Indications were be nign disease in 4 patients and carcinoma in 33. Of the latter, 21 pati ents underwent resection for metachronous lung cancer, 6 for recurrent lung cancer, 4 for previous incomplete resection, 1 for primary lung cancer after previous resection for benign disease acid 1 patient afte r previous segmentectomy for metastasis. The mean interval between fir st operation and completion pneumonectomy was 41 months (range 1-187 m onths) for the whole group, 30 months for benign disease and 42 months for carcinoma. The overall operative mortality was 6/37 (16.2%); 1/4 patients with benign disease and 5/33 (15.2%) patients with carcinoma. Nine patients (29%) had one or more major non-fatal complication. Act uarial 3- and 5-year survival rates were 41.0% and 24.5% for the entir e group, 75% at both times for patients with benign disease, 36.4% and 18.3% for all patients with carcinoma at the time of completion pneum onectomy and 24.3% and 14.59% for patients with metachronous or recurr ent lung cancer. For 15 patients with stage I or II metachronous lung cancer, the 3- and 5-year survival rates were 33.9% and 16.9%. All six patients with stage III metachronous cancer died within 18 months. In conclusion, completion pneumonectomy carries a high operative mortali ty and morbidity. Long-term survival is negatively influenced by stage III lung cancer.