Thorac cardiovasc Surg
DOI: 10.1055/s-0039-1679959
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Outcomes of Carinal Sleeve Resection in Non-Small Cell Lung Cancer

Celal Bugra Sezen
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Celalettin Ibrahim Kocaturk
2  Department of Thoracic Surgery, Istinye University Medical Faculty, Liv Hospital Ulus, Istanbul, Turkey
,
Salih Bilen
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Cem Emrah Kalafat
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Levent Cansever
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Seyyit Ibrahim Dincer
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Mehmet Ali Bedirhan
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

22 November 2018

15 January 2019

Publication Date:
26 February 2019 (online)

Abstract

Background Carinal resections for non-small cell lung cancer (NSCLC) invading the carina are challenging cases that require a therapeutic strategy. The aim of this study was to compare the oncologic outcomes and complications of patients who underwent carinal resection.

Methods Sixty-four patients who underwent carinal resection between 2005 and 2016 were evaluated. Data were retrospectively reviewed for indications, complications, and factors influencing long-term survival.

Results The study included 51 patients (79.7%) who underwent sleeve pneumonectomy (sP) and 13 patients who underwent carinal sleeve lobectomy (csL) as a curative therapy. Nine patients (14.1%) received induction chemotherapy. Complications were observed in 31 patients (48.8%), including 24 patients (47.1%) in the sP group and 7 patients (53.8%) in the csL group (p = 0.662). Six patients (9.4%) developed bronchopleural fistula. The 30-day mortality rate was 10.9% (n = 7). The 5- and 10-year survival rates were 42.2 and 23.1%, respectively. N2 and R1 were identified as factors affecting survival (p = 0.029 and p = 0.047).

Conclusion Carinal resections have acceptable morbidity, mortality, and long-term survival outcomes in central NSCLC. The main factors affecting survival are complete resection and nodal status. The results of csL were similar to those of sP. Therefore, we believe that csL should be performed in all eligible patients.