Lung Resection for Lung Cancer after Pleural Empyema

Abstract Background The association of pleural empyema and lung cancer has traditionally been considered as a contraindication for lung resection. However, several aspects of this problem still remain controversial. Materials and Methods A retrospective study was conducted including 15 patients (12 pneumonectomies and 3 lobectomies) who underwent a lung resection for primary lung cancer after previous pleural empyema. Results In all but one patient, empyema was treated by chest tube for 15 to 40 days. In only two patients, the diagnosis of empyema preceded the diagnosis of lung cancer. Among patients with pneumonectomy, a good intrapleural cleavage plane existed in only one patient with no signs of infection. In each patient with a lobectomy, preoperative chest tube aspiration took 20 to 30 days and in none of them intraoperative signs of infection existed. In patients with pneumonectomy, empyema without bronchopleural fistula occurred in two patients, while in one patient, empyema was associated with fistula. The operative morbidity after pneumonectomy was 33.3%. Conclusion Association of pleural empyema and lung cancer is not an absolute contraindication for surgery. Potentially curative operation is possible, provided a full control of infection is achieved.

[1]  Andrew Shanahan,et al.  A cloud with a silver lining , 2009 .

[2]  R. Rami-Porta,et al.  ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. , 2007, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[3]  T. Demmy,et al.  Pneumonectomy for bronchogenic carcinoma: analysis of factors predicting survival. , 2007, The Annals of thoracic surgery.

[4]  Robert Livingston,et al.  Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. , 2005, The New England journal of medicine.

[5]  P. Froeschle,et al.  Video-thoracoscopy and staged management of preoperative empyema in lung cancer. , 2005, The thoracic and cardiovascular surgeon.

[6]  M. Olschewski,et al.  Comparison of morbidity, 30-day mortality, and long-term survival after pneumonectomy and sleeve lobectomy for non-small cell lung carcinoma. , 2005, The Annals of thoracic surgery.

[7]  J. Kołodziej,et al.  Causes and management of postpneumonectomy empyemas: our experience. , 2004, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[8]  Kenji Suzuki,et al.  Recent results of postoperative mortality for surgical resections in lung cancer. , 2004, The Annals of thoracic surgery.

[9]  R. Schilsky,et al.  Randomized Clinical Trial of adjuvant chemotherapy with paclitaxel and carboplatin following resection in Stage IB Non-Small Cell Lung Cancer (NSCLC): Report of Cancer and Leukemia Group B (CALGB) Protocol 9633. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  G. Giaccone,et al.  Randomized study of adjuvant chemotherapy for completely resected stage I, II, or IIIA non-small-cell Lung cancer. , 2003, Journal of the National Cancer Institute.

[11]  M. Sok,et al.  Sources of pathogens causing pleuropulmonary infections after lung cancer resection. , 2002, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[12]  M. Riquet,et al.  Pleurésies purulentes et cancer du poumon. Formes non latrogènes et prise en charge thérapeutique , 1999 .

[13]  P. Yang,et al.  Needle aspiration biopsy of malignant lung masses with necrotic centers. Improved sensitivity with ultrasonic guidance. , 1993, Chest.

[14]  T. Baró,et al.  Empyema caused by Kingella denitrificans and Peptostreptococcus spp. in a patient with bronchogenic carcinoma. , 1988, The European respiratory journal.

[15]  M R Chaudhuri,et al.  Primary pulmonary` cavitating carcinomas , 2022 .

[16]  N. Vianna Nontuberculous bacterial empyema in patients with and without underlying diseases. , 1971, JAMA.

[17]  P. Goldstraw Postpneumonectomy empyema. The cloud with a silver lining? , 1980, The Journal of thoracic and cardiovascular surgery.