Pii: S1010-7940(01)00823-5

Objective: The purpose of this study was to identify predictors of operative mortality and survival following pneumonectomy for nonsmall cell lung cancer (NSCLC). Methods: All 206 patients having a pneumonectomy for NSCLC between 1991 and 1997 in our unit were prospectively studied. There were 162 males (79%) and 44 females (21%) with a mean age (^ standard deviation) of 61 ^ 7.7 years (range 34±81 years). Squamous cell (75%) and adenocarcinoma (17.0%) were the predominant histological types. The possible impact of 29 parameters on operative mortality and survival was tested with univariate and multivariate analysis. The mean follow-up was 2.3 ^ 1.2 years, ranging between 0 and 6.8 years, and it was complete. Results: Operative mortality was 6.8% (14 deaths). On multiple logistic regression older age (Pˆ 0.04) and the development post-operatively of bronchopleural ®stula (BPF) (Pˆ 0.01) were independent predictors of operative mortality. The overall, Kaplan±Meier, 1-, 3and 5-year survival (^ standard error from the mean), inclusive of operative mortality, was 68 ^ 3.3, 42 ^ 4.1 and 35 ^ 4.5%. On Cox proportional hazards regression adenocarcinoma (Pˆ 0.006), the development of BPF (Pˆ 0.003), older age (Pˆ 0.03) and higher pathological stage (Pˆ 0.02) were independent adverse predictors of survival. Conclusion: Pneumonectomy for NSCLC carries a considerable, but acceptable, operative mortality and provides an important survival bene®t. This study suggests that older age and BPF are major determinants of an unfavourable in-hospital outcome; older age, BPF, adenocarcinoma cell type and higher pathological stage signi®cantly reduce the probability of a long-term survival. q 2001 Elsevier Science B.V. All rights reserved.