HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Barlesi, F. Articles by Fuentes, P. Search for Related Content PubMed PubMed Citation Articles by Barlesi, F. Articles by Fuentes, P. Related Collections Lung - cancer

Eur J Cardiothorac Surg 2001;20:1113-1116
© 2001 Elsevier Science NL

Bilateral bronchioloalveolar lung carcinoma: is there a place for palliative pneumonectomy?

^a Department of Thoracic Oncology, Sainte-Marguerite Hospital, Marseille, France
^b Department of Thoracic Surgery, Sainte-Marguerite Hospital, Marseille, France
^c UPRES, EA 2201, Laboratoire de physiopathologie respiratoire, Faculté de médicine Nord, 35 Bd Pierre Dramard, Marseille, France

Received 13 June 2001; received in revised form 17 August 2001; accepted 22 August 2001.

Corresponding author. Tel.:+33-491-74-47-36; fax:+33-491-75-11-31
e-mail: fbarlesi{at}mail.ap-hm.fr

Objective: Bronchioloalveolar lung carcinoma (BAC) is characterized by bronchial and lymphatic dissemination explaining multifocal and bilateral spreading. Bilateral BAC is usually considered as a contraindication to surgery. Regarding poor efficacy of symptomatic and oncological treatments, we hypothesized that surgery might play a role to palliate hypoxemia associated with serious intrapulmonary shunting, as well as continuous bronchorrhea. Methods: We retrospectively studied here four consecutive patients, who underwent palliative pneumonectomy. Results: The shunt was confirmed again at the time of the surgery by a pulmonary artery occlusion demonstrating immediate improvement in arterial oxygen saturation from 89% at baseline to 98% after occlusion. Lung resections consisted of a left pneumonectomy in three cases and a right pneumonectomy in one. PaO₂ levels under 5 l/min oxygen therapy improved dramatically when comparing preoperative data (mean 50.5 mmHg) to post-operative results (mean 150 mmHg). One patient died postoperatively. Three patients, who experienced an uneventful immediate post-operative course, received chemotherapy after surgery. Improvement of quality of life is testified by the absence of both symptoms and any need for oxygen therapy for few months. Disabling symptoms reappeared at 1, 8 and 10 months. Survival of these patients was 3, 12 and 18 months. Conclusions: These results support the interest of consideration of a surgical resection for highly selected patients presenting with bilateral BAC and severe intrapulmonary shunting.

Key Words: Bronchioloalveolar carcinoma • Pulmonary shunt • Hypoxemia • Surgery

This article has been cited by other articles:

				F. Barlesi, C. Doddoli, C. Gimenez, B. Chetaille, R. Giudicelli, P. Fuentes, J.-P. Kleisbauer, and P. Thomas Bronchioloalveolar carcinoma: myths and realities in the surgical management Eur. J. Cardiothorac. Surg., July 1, 2003; 24(1): 159 - 164. [Abstract] [Full Text] [PDF]