Morbidity of pneumonectomy in the age of neoadjuvant therapy for lung cancer

7176 Background: Recent literature suggests there is a significant difference in morbidity following right pneumonectomy compared to left for lung cancer in the setting of neoadjuvant therapy. The objective of this study was evaluate the morbidity and effects of neoadjuvant therapy in right vs left pneumonectomy for non small cell lung cancer (NSCLC). Methods: A review of all patients who underwent a pneumonectomy for NSCLC at a single institution (1990–2002). Evaluation of outcomes for right vs left pneumonectomy was performed. Statiscal analysis: Chi Square and Fisher Exact. Results: There were 115 patients (65 left: 50 right) who underwent pneumonectomy for NSCLC. Histology was similar between the two groups. Fifty-two of 115 (45%)patients underwent neoadjuvant therapy (right n=25 (50%), left n=27 (42%). The median length of hospital stay was 5 days for both groups. There was no significant difference in the broncho-pleural fistula rate whether neoadjuvant therapy was given or not (right with-4, without-3; left with-1, without-1). Supraventricular arrhythmias were more common in patients with neoadjuvant therapy prior to their pneumonectomy (left 16 of 19, right 3 of 5),p=0.0004. Conclusions: There was no significant difference between right and left pneumonectomies with regard to 30 day mortality and overall median survival. Patients with left pneumonectomies were more likely to have post operative arrhythmias. Patients with right pneumonectomies had more BPFs. Right pneumonectomy is a risk factor for development of BPFs, but neoadjuvant therapy is not. Neoadjuvant therapy is associated with an increase in the risk of supraventricular arrhythmias following pneumonectomy No significant financial relationships to disclose.