Five-year survival after sleeve pneumonectomy combined with the superior vena cava replacement for lung cancer.

The authors report an excellent long-term survival after sleeve pneumonectomy combined with the superior vena cava (SVC) replacement for T4N2M0 non-small cell lung cancer. N2 disease was objectified by mediastinoscopy before an inductive treatment. After three cycles of platinum-paclitaxel combination a partial response was proved. Right pneumonectomy with ePTFE graft replacement of directly invaded SVC was performed. The carinal resection was forced intraoperatively, because of the positive resection margins of the right main bronchus. The direct invasion into SVC, residual N2 disease and definitive free resection margins were confirmed histologically. This patient has survived for 5 years after combined extended lung resection without any relapse; the SVC graft still remains functional.