Prognostic analysis of the bronchoplastic and broncho-arterioplastic lobectomy of non-small cell lung cancers-10-year experiences of 161 patients

• Published in: Journal of thoracic disease Vol. 7; no. 12; pp. 2288 - 2299
• Main Authors: Zhao, Li-Lan, Zhou, Fang-Yu, Dai, Chen-Yang, Ren, Yi-Jiu, Jiang, Ge-Ning, Fei, Ke, Chen, Chang
• Format: Journal Article
• Language: English
• Published: China AME Publishing Company 01.12.2015
• Subjects: Original; bronchoplasty; pulmonary artery; surgery technique; Lung cancer surgery
• ISSN: 2072-1439; 2077-6624
• DOI: 10.3978/j.issn.2072-1439.2015.12.59

Bronchoplastic and broncho-arterioplastic lobectomy is technically demanding. Present study performed a prognostic analysis of lobectomy patient based on 10-year data in a high-volume center. Overall, 161 non-small cell lung cancer (NSCLC) cases underwent bronchoplastic and broncho-arterioplastic lobectomy between January 2004 and November 2013. Follow-up information was obtained for 88.8% patients. Prognostic analysis was performed with the Cox proportional hazards model. There were 133 bronchoplastic and 28 broncho-arterioplastic procedures. In detail, 97 sleeve and 64 wedge broncho-resection and reconstructions were conducted; pulmonary artery sleeve reconstructions were performed in 26 cases and tangential resection in 135 cases. 90-day post-operative mortality was 3.1% (5/161), and 24.8% (40/161) patients had post-operative complications. 5-year overall survival was 53.4% and 5-year disease-free survival (DFS) was 48.2% for the entire case series; these survival rates were 67.7% and 55.7% for stage I (n=31), 64.4% and 58.9% for stage II (n=62), and 36.9% and 31.9% for stage III disease, respectively. Univariate analysis revealed that age >65 and higher grade of pN were associated with worse overall survival while right side tumor, non-squamous histology type, and higher grade of pT and pN were associated with worse DFS. Multivariate analysis revealed that pN is the only independent factor of worse outcome. Bronchoplastic and broncho-arterioplastic lobectomy are safe procedures for indicated NSCLC patients associated with a low rate of post-operative complications but favorable long-term survival. Recognition of prognostic factors helps improve outcomes for these patients.