Surgical Outcomes of Sleeve Resections Performed for Non‑Small Cell Lung Cancer; A Single Center Experience

Abstract

Background: Although bronchial sleeve resections were performed instead of pneumonectomy in patients with insufficient pulmonary function initially, it is currently available as an alternative to pneumonectomy even in patients with adequate pulmonary reserve. Aims: In this study, we aimed to evaluate the sleeve resections performed for lung cancer in terms of technical, postoperative  complication mortality, survival rates and survival factors, complication and to compare them with the literature. Methods: Patients who underwent sleeve lung resection with diagnosis of non‑small cell lung cancer at our department between January 2012 and December 2017 were included in the study. Patients’ data were analyzed according to tumor size, tumor histopathology, hilar/mediastinal lymph nodes invasion status, postoperative complications, operative mortality, resection type, overall survival and diseases‑free survival, tumor location, and length of stay in intensive care unit. Results: A total of 71 patients included the study. Right upper sleeve lobectomy was applied to 40 (56.3%) patients and left upper sleeve lobectomy was performed to 19 (26.8%) patients. The most common histopathological diagnosis was squamous cell carcinoma. The mean tumor diameter was 3.39 (SD: 2.25) cm. There was no nodal invasion in 41 (57.7%) patients and N1 nodal positivity was detected in 18 (25.4%) patients and N2 positivity in 12 (16.9%) patients. Median survival time was 43.6 months (35.4‑51.8 months), the 3‑ and 5‑year overall survival were 65.7% and 40.6%, respectively. There was a statistically significant correlation relationship between nodal invasion and recurrence, but this relation was not found in overall survival. Conclusion: In our study, no significant correlation was found between mediastinal lymph node invasion and overall survival. Supporting this result with multi-centered and prospective studies may encourage surgeons for sleeve resection in indicated patients had lung cancer with nodal invasion.