P-132BRONCHIAL SLEEVE RESECTION OR PNEUMONECTOMY FOR NON-SMALL-CELL LUNG CANCER: A PROPENSITY MATCHED ANALYSIS OF LONG-TERM SURVIVAL AND QUALITY OF LIFE

Objectives: To determine retrospectively postoperative long-term survival and quality of life in patients operated for non-small-cell lung cancer (NSCLC) using sleeve lobectomy (SL) or pneumonectomy. Methods: A total of 641 NSCLC patients were operated between 2000 and 2010. Pneumonectomy was utilized in 67 patients and SL in 40. In 2012 all patients alive were sent validated 15D Quality of Life Questionnaires; of them 83% replied. Results: After propensity score matching analysis 32 bronchial (right 18/left 14), 7 bronchovascular (right 3/left 4) and 1 right-wedge sleeve lobectomy, and 18 right and 22 left pneumonectomies were compared. There were no significant differences between the groups in age, pre- or postoperative stages, preoperative Charlson comorbidity index score, preoperative FEV1 or diffusion capacity. Complication rate (50%) was similar between groups. Major complications in pneumonectomy group: 2 bronchopleural fistulas, 2 empyemas, 1 stroke, 1 A-V block. In sleeve lobectomy group: 1 stroke, 1 empyema, 1 pneumonia, and 1 bleeding. Nine patients in the pneumonectomy group were reoperated and 3 in the sleeve lobectomy group. There was no operative mortality in the sleeve lobectomy group and one (2.5%) in the pneumonectomy group. The 90-day mortality for pneumonectomy was 5% (n = 2) and for sleeve lobectomy 5% (n = 2). No difference was noted in the long-term follow-up for distant metastasis rate or logoregional recurrence. Postoperative quality of life showed no significant difference in different dimensions or total score. The 5-year survival was similar in both groups (P = 0.458), and no death occurred in sleeve lobectomy patients after 5 years of follow-up, but thereafter 50% of pneumonectomy patients died of non-cancerous causes. Conclusions: During the 5-year follow-up, pneumonectomy and sleeve lobectomy showed no significant differences in cancer-specific survival or in quality of life. However, thereafter sleeve lobectomy patients showed better survival. This advocates the use of sleeve lobectomy in central non-small-cell lung cancer when feasible. Disclosure: No significant relationships.