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Mark S. Allen
Gail E. Darling
Taine T.V. Pechet
John D. Mitchell
Rodney J. Landreneau
Richard I. Inculet
David R. Jones
Bryan F. Meyers
David H. Harpole
Valerie W. Rusch
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Right arrow Lung - cancer

Ann Thorac Surg 2006;81:1013-1020
© 2006 The Society of Thoracic Surgeons


J. Maxwell Chamberlain memorial paper

Morbidity and Mortality of Major Pulmonary Resections in Patients With Early-Stage Lung Cancer: Initial Results of the Randomized, Prospective ACOSOG Z0030 Trial

Mark S. Allen, MD * , Gail E. Darling, MD, Taine T.V. Pechet, MD, John D. Mitchell, MD, James E. Herndon, II, PhD, Rodney J. Landreneau, MD, Richard I. Inculet, MD, David R. Jones, MD, Bryan F. Meyers, MD, David H. Harpole, MD, Joe B. Putnam, Jr, MD, Valerie W. Rusch, MD ACOSOG Z0030 Study Group *

Accepted for publication June 24, 2005.

* Address correspondence to Dr Allen, Division of General Thoracic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Email: allen.mark{at}mayo.edu).

Presented at the Forty-first Annual Meeting of The Society of Thoracic Surgeons, Tampa, FL, Jan 24–26, 2005. Winner of the J. Maxwell Chamberlain Memorial Award for General Thoracic Surgery.

BACKGROUND: Little prospective, multiinstitutional data exist regarding the morbidity and mortality after major pulmonary resections for lung cancer or whether a mediastinal lymph node dissection increases morbidity and mortality.

METHODS: Prospectively collected 30-day postoperative data was analyzed from 1,111 patients undergoing pulmonary resection who were enrolled from July 1999 to February 2004 in a randomized trial comparing lymph node sampling versus mediastinal lymph node dissection for early stage lung cancer.

RESULTS: Of the 1,111 patients randomized, 1,023 were included in the analysis. Median age was 68 years (range, 23 to 89 years); 52% were men. Lobectomy was performed in 766 (75%) and pneumonectomy in 42 (4%). Pathologic stage was IA in 424 (42%), IB in 418 (41%), IIA in 37 (4%), IIB in 97 (9%), and III in 45 (5%). Lymph node sampling was performed in 498 patients and lymph node dissection in 525. Operative mortality was 2.0% (10 of 498) for lymph node sampling and 0.76% (4 of 525) for lymph node dissection. Complications occurred in 38% of patients in each group. Lymph node dissection had a longer median operative time and greater total chest tube drainage (15 minutes, 121 mL, respectively). There was no difference in the median hospitalization, which was 6 days in each group (p = 0.404).

CONCLUSIONS: Complete mediastinal lymphadenectomy adds little morbidity to a pulmonary resection for lung cancer. These data from a current, multiinstitutional cohort of patients who underwent a major pulmonary resection constitute a new baseline with which to compare results in the future.




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F. Farjah, D. R. Flum, T. K. Varghese Jr, R. G. Symons, and D. E. Wood
Surgeon Specialty and Long-Term Survival After Pulmonary Resection for Lung Cancer
Ann. Thorac. Surg., April 1, 2009; 87(4): 995 - 1006.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
G. Casali and W. S. Walker
Video-assisted thoracic surgery lobectomy: can we afford it?
Eur J Cardiothorac Surg, March 1, 2009; 35(3): 423 - 428.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
M. Salati, A. Brunelli, F. Xiume, M. Refai, and A. Sabbatini
Quality of life in the elderly after major lung resection for lung cancer
Interact CardioVasc Thorac Surg, January 1, 2009; 8(1): 79 - 83.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
M. Chida, M. Minowa, Y. Karube, S. Eba, Y. Okada, S. Miyoshi, and T. Kondo
Worsened long-term outcomes and postoperative complications in octogenarians with lung cancer following mediastinal lymph-node dissection
Interact CardioVasc Thorac Surg, January 1, 2009; 8(1): 89 - 92.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
N. Barbetakis, G. Samanidis, D. Paliouras, and C. Tsilikas
eComment: Long-term outcomes in octogenarians with lung cancer following mediastinal lymph node dissection
Interact CardioVasc Thorac Surg, January 1, 2009; 8(1): 92 - 92.
[Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
W. Zhong, X. Yang, J. Bai, J. Yang, C. Manegold, and Y. Wu
Complete mediastinal lymphadenectomy: the core component of the multidisciplinary therapy in resectable non-small cell lung cancer
Eur J Cardiothorac Surg, July 1, 2008; 34(1): 187 - 195.
[Abstract] [Full Text] [PDF]


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RadiologyHome page
F. J. Wolf, D. J. Grand, J. T. Machan, T. A. DiPetrillo, W. W. Mayo-Smith, and D. E. Dupuy
Microwave Ablation of Lung Malignancies: Effectiveness, CT Findings, and Safety in 50 Patients
Radiology, June 1, 2008; 247(3): 871 - 879.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
N. Wu, C. Lv, S. Yan, H. Duan, Q. Zheng, J. Wang, H. Xiong, and Y. Yang
Systemic mediastinal lymph node dissection of right lung cancer: surgical quality control and analysis of mediastinal lymph node metastatic patterns
Interact CardioVasc Thorac Surg, April 1, 2008; 7(2): 240 - 243.
[Abstract] [Full Text] [PDF]


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Anesth. Analg.Home page
F. Dexter, E. U. Dexter, D. Masursky, and N. A. Nussmeier
Systematic Review of General Thoracic Surgery Articles to Identify Predictors of Operating Room Case Durations
Anesth. Analg., April 1, 2008; 106(4): 1232 - 1241.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
D. G. Nicastri, J. P. Wisnivesky, V. R. Litle, J. Yun, C. Chin, F. R. Dembitzer, and S. J. Swanson
Thoracoscopic lobectomy: Report on safety, discharge independence, pain, and chemotherapy tolerance
J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 642 - 647.
[Abstract] [Full Text] [PDF]


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The OncologistHome page
C. J.A. Haasbeek, S. Senan, E. F. Smit, M. A. Paul, B. J. Slotman, and F. J. Lagerwaard
Critical Review of Nonsurgical Treatment Options for Stage I Non-Small Cell Lung Cancer
Oncologist, March 1, 2008; 13(3): 309 - 319.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
D. J. Boffa, M. S. Allen, J. D. Grab, H. A. Gaissert, D. H. Harpole, and C. D. Wright
Data from The Society of Thoracic Surgeons General Thoracic Surgery database: The surgical management of primary lung tumors
J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 247 - 254.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
R. M. Flores and N. Alam
Video-Assisted Thoracic Surgery Lobectomy (VATS), Open Thoracotomy, and the Robot for Lung Cancer
Ann. Thorac. Surg., February 1, 2008; 85(2): S710 - S715.
[Abstract] [Full Text] [PDF]


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JCOHome page
S. J. Swanson, J. E. Herndon II, T. A. D'Amico, T. L. Demmy, R. J. McKenna Jr, M. R. Green, and D. J. Sugarbaker
Video-Assisted Thoracic Surgery Lobectomy: Report of CALGB 39802 A Prospective, Multi-Institution Feasibility Study
J. Clin. Oncol., November 1, 2007; 25(31): 4993 - 4997.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
N. Alam, B. J. Park, A. Wilton, V. E. Seshan, M. S. Bains, R. J. Downey, R. M. Flores, N. Rizk, V. W. Rusch, and D. Amar
Incidence and Risk Factors for Lung Injury After Lung Cancer Resection
Ann. Thorac. Surg., October 1, 2007; 84(4): 1085 - 1091.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
P. W. Smith, H. Wang, L. M. Gazoni, K. R. Shen, T. M. Daniel, and D. R. Jones
Obesity Does Not Increase Complications After Anatomic Resection for Non-Small Cell Lung Cancer
Ann. Thorac. Surg., October 1, 2007; 84(4): 1098 - 1106.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. J. Schuchert, B. L. Pettiford, S. Keeley, T. A. D'Amato, A. Kilic, J. Close, A. Pennathur, R. Santos, H. C. Fernando, J. R. Landreneau, et al.
Anatomic Segmentectomy in the Treatment of Stage I Non-Small Cell Lung Cancer
Ann. Thorac. Surg., September 1, 2007; 84(3): 926 - 933.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
B. A. Whitson, S. S. Groth, and M. A. Maddaus
Surgical Assessment and Intraoperative Management of Mediastinal Lymph Nodes in Non-Small Cell Lung Cancer
Ann. Thorac. Surg., September 1, 2007; 84(3): 1059 - 1065.
[Abstract] [Full Text] [PDF]


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cfpHome page
M. Lock and G. Rodrigues
Computed tomographic screening for lung cancer
Can Fam Physician, August 1, 2007; 53(8): 1334 - 1336.
[Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
M. Muraoka, S. Akamine, T. Oka, T. Tagawa, A. Nakamura, T. Tsuchiya, T. Hayashi, and T. Nagayasu
Sentinel node sampling limits lymphadenectomy in stage I non-small cell lung cancer
Eur J Cardiothorac Surg, August 1, 2007; 32(2): 356 - 361.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
W. Sienel, C. Stremmel, A. Kirschbaum, L. Hinterberger, E. Stoelben, J. Hasse, and B. Passlick
Frequency of local recurrence following segmentectomy of stage IA non-small cell lung cancer is influenced by segment localisation and width of resection margins -- implications for patient selection for segmentectomy
Eur J Cardiothorac Surg, March 1, 2007; 31(3): 522 - 528.
[Abstract] [Full Text] [PDF]


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ThoraxHome page
G. M Wright, J-E C Holty, and M K Gould
When in doubt should we cut it out? The role of surgery in non-small-cell lung cancer
Thorax, February 1, 2007; 62(2): 190 - 191.
[Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
A. Brunelli, N. J. Morgan-Hughes, M. Refai, M. Salati, A. Sabbatini, and G. Rocco
Risk-adjusted morbidity and mortality models to compare the performance of two units after major lung resections
J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 88 - 96.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
E. Belcher and P. Goldstraw
Is radical mediastinal dissection mandatory for curative resection of NSCLC?
Eur J Cardiothorac Surg, January 1, 2007; 31(1): 142 - 143.
[Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
S. Ganti, R. Milton, V. Anikin, and A. Thorpe
Surgery for tumour recurrence in a pneumonectomy space
Eur J Cardiothorac Surg, October 1, 2006; 30(4): 683 - 685.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
F. Leo, P. Solli, G. Veronesi, D. Radice, A. Floridi, R. Gasparri, F. Petrella, A. Borri, D. Galetta, and L. Spaggiari
Does chemotherapy increase the risk of respiratory complications after pneumonectomy?
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 519 - 523.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. El-Sherif, W. E. Gooding, R. Santos, B. Pettiford, P. F. Ferson, H. C. Fernando, S. J. Urda, J. D. Luketich, and R. J. Landreneau
Outcomes of Sublobar Resection Versus Lobectomy for Stage I Non-Small Cell Lung Cancer: A 13-Year Analysis
Ann. Thorac. Surg., August 1, 2006; 82(2): 408 - 416.
[Abstract] [Full Text] [PDF]


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ThoraxHome page
J-E C Holty and M K Gould
When in doubt should we cut it out? The role of surgery in non-small cell lung cancer.
Thorax, July 1, 2006; 61(7): 554 - 556.
[Full Text] [PDF]




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