Sleeve Lobectomy Compared to Pneumonectomy for the Treatment of N0-N1 Non-Small Cell Lung Cancer

Abstract

To compare survival, morbidity, and mortality rates for a series of patients who underwent either bronchoplastic sleeve lobectomy or pneumonectomy to treat non-small cell lung cancer (NSCLC). We reviewed the clinical records for patients who underwent sleeve lobectomy or pneumonectomy for NSCLC from January 1994 through December 2003. From January 1994 through December 2003, 35 sleeve lobectomies and 220 pneumonectomies were performed at our department on patients with NSCLC. The perioperative mortality rate was 2.8% for the lobectomy group and 9.1% for the pneumonectomy group. The mean survival time for the pneumonectomy group was 45 months (95% confidence interval [CI], 37-53), with a 5-year survival rate of 32% (SE, 5.1%). The mean survival time for the sleeve lobectomy group was 72 months (95% CI, 56-87) (P< or =.0041), with a 5-year survival rate of 56% (SE, 9.6%). If we stratify the groups according to node involvement, patients classified as N0-N1 had a mean survival time of 52 months (95% CI, 43-61), with a 5-year survival rate of 39% (SE, 6.2%) for the pneumonectomy group. The mean survival time for patients undergoing sleeve lobectomy was 75 months (95% CI, 59-92) (P< or =.018), with a 5-year survival rate of 60% (SE, 10.4%). Survival for patients with N2 disease was similar to that of patients with N0-N1 disease. For patients with N0-N1 non-small cell lung cancer, sleeve lobectomy offers better survival than pneumonectomy.