CANCER RESECTION ON THE RESIDUAL LUNG AFTER PNEUMONECTOMY FOR BRONCHOGENIC-CARCINOMA

Background. After pneumonectomy for bronchogenic carcinoma, the residu al lung may be the site of a new lung cancer or metastatic spread. Met hods. From 1989 to 1995, 13 patients with carcinoma on the residual lu ng after pneumonectomy for lung cancer were operated on. Three segment ectomies and 7 simple wedge resections were performed, 2 patients had multiple wedge resections, and I patient had an exploratory thoracotom y. Nine patients had a primary metachronous bronchogenic carcinoma, 3 had metastases from bronchogenic carcinoma, and no definite conclusion was reached in 1 case. Results. No postoperative mortality was observ ed. Four patients had postoperative complications. The mean postoperat ive hospital stay was 14 days. Seven patients are alive, including 5 p atients without evidence of disease. Six patients died of their diseas e, all with pulmonary recurrences. The overall median survival was 19 months, with a probability of survival at 3 years (Kaplan-Meier) of 46 % (95% confidence interval, 22% to 73%). Conclusions. Limited pulmonar y resection for lung cancer after pneumonectomy for bronchogenic carci noma is feasible with very low morbidity. In highly selected patients, surgical resection might prolong survival.