The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, pericardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy". From March 1990
to
February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial resection, and one patient had resection of diaphragm.
Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years)with male to female ratio of 17 to 1. The chief complaints of the patients on admission were
cough(13),
dyspnea on exertion(11), chest pain(10), weight loss(9), general fatigue(9), and sputum production(4).
Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3N0M0, 4 T3N1M0, 6 T3N2M0, 5 T4N2M0, and 1 T2N1M0.
There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07±4.82months. One patient with stage T3N0M0 who had chest wall resection is alive at 35 months follow-up
and a
patient with T3N2M0 who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "comples pneumonectomy" is very importam, and a long term survival is possible.
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