P1.08-082 Surgical Techniques and Long-Term Results of the Pulmonary Artery Reconstruction in Patients with Lung Cancer

Abstract

Pulmonary artery (PA) reconstruction for lung cancer is technically feasible with low morbidity and mortality. We assessed our experience with partial or circumferential resection of PA during lung resection. Between 1998 and 2015, we performed PA angioplasty in 150 patients with lung cancer. Seventy-five patients received induction chemotherapy (IC). Partial PA resection was performed in 146 cases. PA reconstruction was performed by running suture in 113 and using a pericardial patch in 33. A circumferential PA resection was performed in 4 patients and reconstruction was made in PTFE and by a custom-made bovine pericardial conduit each. Bronchial sleeve resection was associated in 56 cases. Thirty-two patients had stage I disease, 43 stage II, 51 IIIA, and 17 IIIB. Seven patients had a complete response after IC. Thirty-day mortality was 3.3% (n=5); two of these patients had a massive hemoptysis leading to death; 33 patients had pulmonary complications, 28 cardiac, 17 air leaks. Overall 5- and 10-year survival was 50% and 39%, respectively. Five- and 10-year survival for stages I and II versus stage III was, respectively, 66% versus 32% and 56% versus 20% (p<.0001). Five-year survival was 61% for N0 and N1 nodal involvement versus 28% for N2, respectively; 10-year survival was 45% versus 28% (p=.001). IC did not influence survival. Multivariate analysis yielded advanced stage, N2 status, and squamous cell carcinoma as negative prognostic factors. PA reconstruction is safe, with excellent long-term survival. Our results support this technique as an effective option to pneumonectomy for patients with lung cancer.