Abstract:
Objective: To analyze the surgical results of sleeve lobectomy plus arterioplasty of pulmonary artery (PA)or angioplasty of superior vena cava (SVC) for lung cancer and to discuss the T grade of tumor invading extrapericardialPA.
Methods: We retrospectively reviewed the data from 53 patients with lung cancer who received sleeve lobectomy plusarterioplasty of PA or angioplasty of SVC in our hospital from September 1981 to January 2007. There were 42 males and11 femals, with a median age of 59 years (range 33~71). According to the invading site, these patients were divided intotwo groups: the tumor invading superior vena cava group and the tumor invading pulmonary artery group. And according topathological lymph node status, these patients were divided into three groups: N
0, N
1and N
2 group.
Results: Of the 53 pa-tients, 41 received sleeve lobectomy plus arterioplasty of PA (13 sleeve resection and 28 tangential resection); and 12 re-ceived angioplasty of SVC (3 sleeve resection and 9 tangential resection). The complication rate was 15.1%(8/53). The 5-year survival was 38.5% for all of the patients, 42.9% for patients in the PA group and 22.2% for patients in the SVCgroup. Pathological lymph node status significantly influenced the survival period (10 months in N
2 group, 24 months in N
1group, and 26 months in N
0 group.
P<0.05). Cox regression analysis showed that pathological lymph node status was anindependent prognostic factor (
P=0.002, RR=2.836, 95% CI:1.330~6.049).
Conclusion: For patients with lung cancer,lobectomy plus arterioplasty of PA or angioplasty of SVC can be accomplished safely and the postoperative complicationrate is acceptable. Patients with pathological N
0-1 lung cancer may benefit from surgical treatment. Before surgery, weshould carefully evaluate the mediastinal lymph node status. Tumor invading extrapericardial PA should be defined as T2.