Long-term outcome of pleuropneumonectomy for Masaoka stage IVa XXXX .

@entity1 @entity1737 @entity704 @entity260
OBJECTIVE: Because pleuropneumonectomy is associated with a high mortality rate, its indication for the treatment of Masaoka stage IVa @entity704 is debated. We reviewed retrospectively our single-center experience in order to determine if the benefits warrant the risk of such procedure. METHODS: Between 1970 and 2009, 17 @entity1 (12 @entity1 and 5 @entity1 ) with a mean age of 44 years (range, 25-62 years) underwent a pleuropneumonectomy for a Masaoka stage IVa @entity704 in our institution. Eight @entity1 had recurrent @entity704 after a mean postoperative period of 47    28 months, and nine @entity1 presented de novo with stage IVa disease. A multimodality treatment including chemotherapy, radiotherapy, or both was performed in 14 (82%) @entity1 . RESULTS: Eight @entity1 (47%) experienced a major @entity260 , including four broncho-pleural fistulae (23%). There were no operative deaths and the 30-day mortality was 17.6% (3/17). But two @entity1 died at 2 and 3 months, increasing the postoperative mortality to 29.4% (5/17). Complete resection was achieved in 11 (65%) @entity1 . By univariate analysis, @entity1737 was the only risk factor for broncho-pleural fistulae. With a median survival of 76 months and median follow-up of 59 months (range, 1-262 months), 5-year and 10-year survivals were 60% and 30%, respectively. During follow-up, a recurrence occurred in two @entity1 at 26 and 87 months, respectively, which was treated medically without success. CONCLUSIONS: Pleuropneumonectomy for Masaoka stage IVa @entity704 is associated with a high morbid-mortality rate. However, included in a multimodality strategy and in highly selected @entity1 this procedure may provide good long-term survival.
