F-084PERFORMING SLEEVE LOBECTOMY INSTEAD OF PNEUMONECTOMY FOR NON-SMALL LUNG CANCER WITH N1 NODAL DISEASE DOES NOT COMPROMISE LONG-TERM SURVIVAL

Objectives N1 nodal disease may be a risk factor for developing locoregional recurrence after sleeve lobectomy for non-small cell lung cancer (NSCLC). We evaluated if sleeve lobectomy had worse survival compared to pneumonectomy for NSCLC with N1 disease involvement. Methods A retrospective review was performed of all patients with T2-3N1M0 NSCLC who underwent pneumonectomy or sleeve lobectomy at a single institution from 1999 to 2011. Survival was determined with the Kaplan-Meier method, and multivariable Cox proportional hazards regression was used to evaluate the impact of resection extent on survival. Results During the study period, 87 patients underwent resection for T2-3N1M0 NSCLC with pneumonectomy (n = 52, 60%) or sleeve lobectomy (n = 35, 40%). Pneumonectomy and sleeve lobectomy patients had similar mean (SD) ages (60.9 ± 10.7 vs 63.5 ± 12.7, P = 0.30), gender distribution (69.2% [36 of 52] vs 60.0% [21 of 35] male, P = 0.37), mean FEV1 (66.3 ± 15.9 vs 63.5 ± 17.6, P = 0.47), mean DLCO (70.2 ± 17.4 vs 74 ± 24.6, P = 0.11), tumour stage (61.5% [32 of 52] vs 62.9% [22 of 35] stage II, P = 0.90), and tumour grade (51.9% [27 of 52] vs 31.4% [11 of 35] well/moderately differentiated, P = 0.17), respectively. Postoperative mortality (3.9% [2 of 52] vs 5.7% [2 of 35], P = 0.68) and length of stay (5 [IQR 4-7] vs 5 [4-7] days, P = 0.68) were similar between the two groups. Three-year survival after pneumonectomy (46.8% [95% CI: 31.8-60.4%]) and sleeve lobectomy (65.2% [45.5-79.3%]) were not significantly different (P = 0.23). In multivariable survival analysis that included age, resection extent, stage, and grade, only increasing age predicted worse survival (HR 1.03/year, P = 0.03). Conclusions Performing sleeve lobectomy instead of pneumonectomy for NSCLC with N1 nodal disease does not compromise long-term survival. Disclosure All authors have declared no conflicts of interest.