Survival outcomes of pneumonectomy with left atrial resection for non-small cell lung cancer

Background: Lung cancer invading left atrium is accepted as T4 tumor and surgical treatment in this situation is controversial. The aim of our study was to determine the prognostic factors of patients with surgically treated non-small cell lung cancer (NSCLC) invading left atrium. Methods: After the approval of local ethics committee, the study was conducted in Gazi University, Department of Thoracic Surgery (Ankara-Turkey). The records of the patients were obtained from the encrypted hospital management software. Sequential codes were given to the data of patients and it was transferred to the statistics program without their names and ID numbers. The data of patients were collected as follows: those who had extended pneumonectomy from the surgery reports were found, then their pathology reports were examined, and those who had atrial muscle tissue were included in the study. Selected cases included as follows: patients who were medically suitable for surgery, patients who could tolerate surgery in cardiology evaluation, patients who had adequate lung capacity for pneumonectomy. Data of patients were analyzed according to age, gender, lymph node invasion, complete resection, and operative mortality. Results: A total of 18 patients were included in the study. There were 16 (88.8%) men and 2 (12.2%) women. The mean age was 60.8 (range: 44 -76; Standard deviation: +/- 1.8) years. Cardiopulmonary bypass was used in only one patient. The 30-day mortality was 5.5%. 1, 3, and 5-years overall survivals were 77%, 18.6%, and 9.3%, respectively. Mediastinal lymph node metastasis in N1 and N2 stations was detected 10 and 2, respectively. There was statistically significant correlation between recurrence and lymph node invasion status including N1 and N2 station (P = 0.04). Conclusion: Although surgery is controversial in patients with NSCLC invading left atrium, it can be performed in selected cases. Morbidity and mortality rates were acceptable.