Pneumonectomy – permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non- small cell lung cancer

Introduction
Despite the constant decrease of performed pneumonectomies (PN) in recent years, it is still necessary for 15–20% of patients with non-small cell lung cancer (NSCLC) to undergo total lung resection due to the local progression of the disease. The aim of the study was to assess the frequency and type of postoperative complications, quality of life, and the early and long-term results after PN performed due to NSCLC.

Material and methods
In the total group of 1160 patients, operated on in 2008–2011 due to NSCLC, 192 of them underwent PN (16.6%). The quality of life was analysed using EORTC-QLQ-C30 questionnaire.

Results
Perioperative mortality after PN was 4%. Five-year survival reached 45%. The factors that significantly affected the 5-year survival in multivariate analysis were: pTNM stage, pN stage, intrapericardial resection, and additional extrapulmonary structures resection. The mean Global Quality of Life was 50.8. The Symptom Scale ranged from 7 to 54.3, the Functional Scale from 58.2 to 76.3 and the rate for NSCLC symptoms ranged from 2.2 to 48.1.

Conclusions
Pneumonectomies in patients with NSCLC is associated with higher risk of postoperative complications but it does not significantly increase the perioperative mortality. Long-term results in this group of patients are encouraging. According to the questionnaire, the quality of life is favourable. Low intensity of typical NSCLC symptoms was observed. The appropriate qualification for right-sided PN and exclusion of metastasis in N2 nodes are crucial.