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Ann Thorac Surg 1991;52:1096-1101
© 1991 The Society of Thoracic Surgeons

Articles

TNM staging and long-term follow-up after sleeve resection for bronchogenic tumors

Paul E. Van Schil, MD, Aart Brutel de la Riviére, MD, Paul J. Knaepen, MD*, Henri A. van Swieten, MD, Jo J. Defauw, MD, Jules M. van den Bosch, MD

Departments of Thoracic Surgery and Pulmonary Medicine, Antoniushospital, Nieuwegein, Netherlands

* Address reprint requests to Dr Knaepen, Department of Thoracic Surgery, Antoniushospital, Postbus 2500, 3430 EM Nieuwegein, Netherlands.

From 1960 to 1989, 145 patients (132 men and 13 women) with a mean age of 60.3 years underwent sleeve lobectomy or sleeve resection of a main bronchus for a bronchogenic tumor. Squamous cell carcinoma was predominantly found (116 patients, 80.0%), followed by carcinoid tumor in 13 patients (9.0%). Postoperative staging was: stage I, 61 patients (42.1%); stage II, 47 (32.4%); stage IIIA, 33 (22.8%); and stage IIIB, 4 (2.7%). Thirty-day mortality was 4.8% (7 patients). Follow-up was complete except for 1 patient who was lost to follow-up 4 years after operation. For the whole group, 5-, 10-, and 15-year survival rates were 49%, 37%, and 18%, respectively. Better survival was noted in patients with carcinoid tumor and squamous cell carcinoma. Considering 112 patients with T2 and T3 squamous cell carcinoma, 5- and 10-year survival rates for No disease (52 patients) were 59% and 47%, for N1 disease (51 patients) 21% and 0%, and for N2 disease (9 patients) 44% and 0%. Differences between N1 and N2 disease were not statistically significant. Survival after sleeve resection is best for carcinoid tumors and squamous cell carcinoma with negative nodes. Presence of N1 or N2 disease significantly worsens prognosis, with no 10-year survivors and no difference between N1 and N2 status.




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