• Richard Warwick, Neeraj Mediratta, Michael Shackcloth, Richard Page, James McShane, Matthew Shaw, and Michael Poullis.
• Liverpool Heart and Chest Hospital, Liverpool, UK.
• Asian Cardiovasc Thorac Ann. 2014 Jan 1;22(1):49-54.

BackgroundPneumonectomy is associated with a higher operative mortality rate and worse 5-year survival after resection for non-small-cell lung cancer, compared to lobectomy. We investigated whether pneumonectomy is an independent risk factor for hospital mortality and poor long-term survival, after risk factor adjustment.MethodsWe analyzed a prospectively validated thoracic surgery database. Kaplan-Meier survival curves were constructed for patients who had undergone lobectomy (n = 1484) or pneumonectomy (n = 266). Logistic and Cox multivariate regression analysis and propensity matching were performed on hospital mortality and long-term survival data.ResultsUnivariate analysis demonstrated that pneumonectomy was a significant risk factor for hospital death (p = 0.02) and long-term survival (p < 0.001). Logistic regression failed to demonstrate pneumonectomy as a risk factor for hospital mortality. Cox regression analysis failed to identify pneumonectomy as a statistically significant risk factor. Propensity analysis (n = 266 in each group with 1:1 matching) demonstrated that pneumonectomy was not associated with hospital mortality (p = 0.37) or poorer long-term survival (p = 0.19) compared to lobectomy.ConclusionPneumonectomy is not an independent risk factor for hospital mortality or long-term survival, after adjustment for confounding factors.

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