Outcome from surgery of lung cancer invading the carina

By 1995, 17 patients with lung cancer invading the carina underwent surgical resection and reconstruction of the carina. Procedures which applied to patients were two cases of wedge pneumonectomy, seven cases of sleeve pneumonectomy, four cases of carinal reconstruction with right upper lobectomy, and four cases of carinal resection and reconstruction. Overall survival for five years were 40.3% and 33.6% for ten years survival. Operative death occurred in 5 cases. Long term survival was achieved in localized diseases which showed no lymph node extension. As for N1 and N2 diseases, only one patient among 7 cases survives 12 months. Thus we conclude that selected cases which showed localized disease without lymph node extension are the candidate for carinal resection and reconstruction. Postoperative intensive care is mandated for these patients. Adjuvant therapy with surgery for these patients with lymph node progression is a future problem.