Okan KARATAŞ, Berkay ŞEN, Nilay ÇAVUŞOĞLU YALÇIN, Gürhan Sinan ÖZGÜNLÜ, Ayşegül GÜLER, Emin MERT, Muharrem ÖZKAYA
Current Thoracic Surgery - 2026;11(1):62-71
Background: Extended lung resections for non-small cell lung cancer (NSCLC) requiring en bloc resection of adjacent structures remain technically demanding procedures and are associated with considerable perioperative risk. This study analyzes the outcomes of 29 consecutive patients undergoing extended lung resections, focusing on survival outcomes and potential prognostic factors. Materials and Methods: We retrospectively analyzed 29 patients who underwent extended lung resections for non-small cell lung cancer (NSCLC) with suspected or confirmed invasion of adjacent structures between 2015 and 2023 at our institution. Extended resections included en bloc removal of structures such as the chest wall, pericardium, diaphragm, or vascular structures when necessary to achieve tumor clearance. Patient demographics, operative characteristics, pathological findings, postoperative complications, and long-term survival outcomes were evaluated using Kaplan-Meier survival analysis. Results: The cohort included 26 males (89.7%) and 3 females (10.3%) with a mean age of 64.4 +/- 10.7 years. Squamous cell carcinoma was the predominant histology (65.5%). TNM staging revealed Stage IB (34.5%) and Stage IIA (20.7%) as most frequent. All patients underwent thoracotomy with extended resections: chest wall (58.6%), pericardium (20.7%), and combined procedures (20.7%). R0 resection was achieved in 51.7% of patients. Mean operative time was 159 +/- 62 minutes. Postoperative complications occurred in 27.6% of patients, with zero 30-day mortality. Mean follow-up was 29.4 +/- 24.1 months with overall mortality of 72.4% and median survival of 24.0 months. Chest wall resection patients had higher mortality (82.4%) compared to other extended procedures (58.3%). Conclusions: Extended lung resections may be performed with acceptable operative mortality in carefully selected patients. However, long-term survival remains limited, particularly in patients requiring chest wall resection. Rigorous patient selection and multidisciplinary evaluation are crucial for optimal outcomes.
