Long-term prognosis of patients with non-small cell lung cancer after bilobectomy and the associated risk factors

Objective: To determine the long-term outcomes associated with bilobectomy for non-small cell lung cancer (NSCLC) and to identify the associated risk factors. Methods: A cohort of 260 patients with NSCLC who underwent bilobectomy was enrolled in this study from June 2005 to January 2015 at our hospital. The clinical data of these patients were reviewed and analyzed retrospectively. All 260 patients were followed up from 12 months to 71 months with a median period of 54 months. Survival analysis were conducted to evaluate the 5-year and 10-year overall survival and disease-free survival, and the risk factors associated with prognosis were further identified. The risk factors associated to poor prognosis were confirmed by the Cox regression analysis. Results: Among 260 patients, there were 150 patients undergoing upper and middle bilobectomy and 110 patients receiving middle and lower bilobectomy. No patients died during surgery or within 30 days postoperatively. The complications within 30day was 30.8%. Patients were followed-up from 12 months to 71 months with a median period of 54 months. Until the last follow-up (June 2016), a total of 116 deaths and 31 recurrences were reported. The 5and 10-year overall survivals were 60% and 55.3%, respectively; the 5and 10-year disease-free survivals were 50.8% and 43.5%, respectively. Cox regression analysis showed that clinical stage III and N2 disease were independent risk factors associated to poor prognosis. Conclusions: Bilobectomy is effective in the treatment of non-small cell lung cancer with a satisfactory long-term survival outcome.