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The Annals of Thoracic Surgery, Vol 57, 960-965, Copyright © 1994 by The Society of Thoracic Surgeons
R Tsuchiya, H Asamura, H Kondo, T Goya and T Naruke
One hundred one patients with locally advanced lung cancer underwent
combined resection of the lung and the left atrium with or without the
great vessels. A single additional organ was resected in 92 patients, two
organs in 8 patients, and three organs in 1 patient. The left atrium was
resected in 44 patients, the superior vena cava in 32, the adventitia of
the aorta in 21, the aorta in 7, and the pulmonary artery in 7. The most
important factors affecting survival defined by multivariate analysis were
postoperative pneumonia, complete resection, postoperative bleeding, and
lymph node metastasis (p < 0.05). Thirteen patients survived 3 years or
more and 10 of the 13 survived 5 years or more. The 5-year survival rate
for all patients, including 8 with operative death, was 13%, and the median
survival time was 9.2 months. The 5-year survival and median survival time
were 19% and 13.8 months after complete resection and 0% and 6.5 months
after incomplete resection (p < 0.01). The 5-year survival and median
survival time for patients with pathologic stage IIIA, IIIB, and IV were
16.8% and 16.8 months; 18.3% and 9.8 months; and 0% and 5.4 months,
respectively. There was a significant difference between stages IIIA plus
IIIB and stage IV (p < 0.05). The 5-year survival after left atrium
resection was 22%. Extended resection was worthwhile for the patients
undergoing complete resection and without postoperative complications.
ARTICLES
Extended resection of the left atrium, great vessels, or both for lung cancer
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
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