Objective:Non small cell lung cancer (NSCLC) is the second most common cancer in Iceland. We studied the indications and surgical outcome of lobectomy for NSCLC in Iceland.

Materials and methods: 213 consecutive patients underwent lobectomy for NSCLC between 1999 and 2008. Data on indications, histology, TNM-stage and complications were analysed, and logistic regression used to assess outcome predictors.

Results: The majority of patients (60%) were referred because of symptoms, whereas 40% were asymptomatic. Adenocarcinoma (62%) and squamous cell carcinoma (29%) were the most frequent histological types. Operative staging showed that 59.6% of cases were stage I, 17.8% were stage II, 7% were stage IIIA and 14.6% were stage IIIB or IV. Mediastinoscopy was performed in 13.6% of cases. Mean operative time was 128 min., operative bleeding 580 ml and median hospital stay 10 days. Sixteen patients (7.5%) had major complications and 36 (17.5%) had minor complications, such as atrial fibrillation and pneumonia. Twelve patients required reoperation, most often due to bleeding, but two had empyema and one had a bronchopleural fistula. Older patients with high ASA scores and extensive smoking history were at increased risk for complications.No patient died within 30 days of surgery whereas two (0,9%) died within 90 days of surgery.

Conclusions: The results of lobectomy for NSCLC in Iceland are excellent in relation to operative mortality and short term complications.

Fig. 1. Ratio of incidental detections for 213 patients with NSCLC who underwent lobectomy in Iceland 1999 – 2008.

Table I: Ratio of patients with NSCLC who underwent lobectomy in Iceland amongst all NSCLC cases diagnosed 1999 – 2008.

Table II: Symptoms in 128 patients (incidentally detected cases excluded) who underwent lobectomy in Iceland 1999 – 2008. Patients can have more than one symptom at the same time. (Number of patients with % in parenthesis).

Table III: Patient demographics together with other risk factors for 213 patients undergoing lobectomy in Iceland 1999 – 2008. (Number of patients with % in parenthesis unless otherwise stated).

Table IV.  Complications in 213 patients who underwent lobectomy for NSCLC in Iceland 1999 – 2008. Patients can have more than one complication. (Number of patients with % in parenthesis).