Læknablaðið - 15.12.2009, Page 17

FRÆÐIGREINAR
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Results of pneumonectomy for non-small cell lungcancer in lceland
Objective: Study the indications, complications and
surgical outcome of pneumonectomy for non small cell
lung cancer (NSCLC) in lceland
Material and methods: A retrospective study of all
pneumonectomies performed for NSCLC in lceland from
1988 to 2007. Information was obtained from medical
records and data on operative indications, postoperative
TNM stage, complictions, survival and survival predictors
was analysed.
Results: 77 patients (64% males) with mean age of
62.3 yrs. were operated on, 44% on the right side.
Mediastinoscopy was performed in 31 % of cases. Most
patients were stage I or II (58%), but 17 and 21% were
stage III A and IIIB, respectively. Mean operation time
was 161 min., bleeding 1.1 Land hospital stay 11 days.
Atrial fibrillation (21%), pneumonia (6.5%), empyema
(5.5%) and respiratory failure (5%) were the most common
complications. Three (3.9%) patients died within 30 days
from surgery. Five year survival was 20.7%. Age, history
of COPD, adenocarcinoma histology and advanced TNM
stage were independent predictors of poor survival.
Conclusions: Pneumonectomies for NSCLC in lceland
have a low rate of complications and operative mortality.
However, long term survival is lower than expected, and
many patients (27%) were in advanced stages. This is
most likely due to inadequate preoperative staging.
Thorsteinsson H, Alfredsson H, Isaksson HJ, Jonsson S, Gudbjartsson T.
Results of pneumonectomy for non-small cell lungcancer in lceland. Icel Med J 2009; 95:823-9
Key word: Lung cancer, pneumonectomy, results, complications, survival, predictors ofsurvival, multivariate analysis.
Correspondence: Tómas Guðbjartsson, tomasgud@landspitali.is
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Barst: 7. júlí 2009, - samþykkt til birtingar: 21. október 2009
LÆKNAblaðið 2009/95 829