- Lung transplantation has the potential for increased survival and improved QoL in patients with primary bronchogenic cancer (NSCLC or multifocal bronchioalveolar cell carcinoma), but uncertainties surround its benefits.
Why this matters
- This qualitative review offers research recommendations to help guide allocation of a scarce resource.
- Lung transplant is rare for bronchogenic cancer, with only 0.13% of all lung transplants for this purpose from 1987 to 2010.
- Lung transplant is currently indicated for early-stage disease for which conventional surgery is contraindicated by poor lung function and the likelihood of short-term mortality.
- About 30% of lung recipients die from distant metastatic disease the first few years after transplant because it contained an unexpected malignancy.
- During lung transplant for multifocal bronchioalveolar cell carcinoma, care must be taken to avoid contamination of donor lung with residual cancer cells in the upper airways.
- Limited conclusions can be drawn about the benefits of lung transplant because of its rarity and the lack of trials comparing lung transplantation with conventional cancer care.
- Research is needed on many fronts, including whether a subgroup of patients can be identified with a survival advantage after lung transplantation.