BACKGROUND: Recent data from prospective multimodality trials have documented an unacceptable early mortality with pneumonectomy after induction chemotherapy. This finding has raised skepticism toward pneumonectomy as a surgical option for @entity1 with regionally advanced @entity1149 . In the current study, perioperative outcomes after pneumonectomy with or without neoadjuvant therapy are compared to determine the impact of induction therapy on perioperative mortality in this setting. Variables associated with increased perioperative risk are identified. METHODS: A review of 315 @entity1149 @entity1 (196 male [62%]) undergoing pneumonectomy over a 15-year period was undertaken. @entity1 were well matched for clinical variables other than receiving induction chemotherapy. Complications and operative mortality were analyzed for associations with laterality and induction chemotherapy. RESULTS: Median age was 64 years, (range, 25 to 82). Age was predictive of mortality in 13 of 86 @entity1 (15%) more than 70 years old, compared with 16 of 229 @entity1 (7%) less than 70 years old (hazard ratio = 1.77, p = 0.046). Overall operative mortality was 9.2% (29 of 315). There were 115 left-sided (37%) and 200 right-sided (63%) pneumonectomies. Sixty-eight @entity1 (22% [left = 31, right = 37]) received induction chemotherapy. Surgery alone was performed in 247 @entity1 . Mortality among @entity1 undergoing induction chemotherapy was 21% (odds ratio = 4.01; p = 0.0007). After induction chemotherapy, postoperative @entity292 associated with @entity1576 was predictive of operative mortality (hazard ratio = 148, p = 0.0001). @entity10584 did appear to a have a greater incidence of postoperative @entity943 . CONCLUSIONS: Morbidity and mortality after pneumonectomy is substantial. @entity1 greater than 70 years old appear to be at increased risk. Induction chemotherapy also increases the risk of operative mortality after pneumonectomy. @entity1 should be advised of this increased operative risk, and the multidisciplinary team must consider this when pneumonectomy appears necessary after induction therapy for locally advanced @entity1149 .

Risk of pneumonectomy after induction therapy for locally advanced XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['nonsmall-cell lung cancer'] @entity292 :: ('MESH:D005402', 'Disease') :: ['bronchopleural fistula'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure'] @entity10584 :: ('MESH:C537001', 'Disease') :: ['Left-side pneumonectomy'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmia']
@entity1149 :: (MESH:D002289,Disease) :: ['non-small cell lung cancer']
