Is Surgery after Chemoradiotherapy Feasible in Lung Cancer Patients with Superior Vena Cava Invasion?

Research output: Contribution to journalArticle

Abstract

PURPOSE: The purpose of this study is to explore the possibility of surgery after chemoradiotherapy (CRT) for locally advanced-non-small-cell lung cancer (LA-NSCLC) with superior vena cava (SVC) resection in terms of prognosis and early and late postoperative course.

METHODS: The medical records of NSCLC patients who underwent surgery after CRT at our institution between January 2001 and March 2016 were reviewed. We evaluated the feasibility of surgery with SVC resection after CRT.

RESULTS: A total of 8 LA-NSCLC patients were enrolled in this study. The SVC management included a graft replacement in two patients, pericardial patch repair in two, and direct suture closure in four. A complete resection was achieved in seven of the eight patients (87.5%). Postoperative early and late complication rate (Clavien-Dindo classification ≥ grade III) was 25%. All the complications were manageable, and no treatment-related deaths occurred in this series. Although seven out of eight patients showed good patency of reconstructed SVC, one patient exhibited the SVC occlusion during long-term follow-up period. Regarding the prognosis, the 5-year overall survival (OS) rate was 60.0%, and the 2-year recurrence-free survival (RFS) rate was 75.0%.

CONCLUSION: Our results suggest that surgery with SVC resection after CRT is a feasible procedure in terms of clinical outcomes and postoperative course.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalAnnals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
Volume24
Issue number3
DOIs
Publication statusPublished - Jun 20 2018

Fingerprint

Superior Vena Cava
Chemoradiotherapy
Lung Neoplasms
Non-Small Cell Lung Carcinoma
Survival Rate
Sutures
Medical Records
Transplants
Recurrence

Keywords

  • chemoradiotherapy
  • non-small-cell lung cancer
  • superior vena cava

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Gastroenterology

Cite this

@article{dd5439a81e2149fdb05afb232f186104,
title = "Is Surgery after Chemoradiotherapy Feasible in Lung Cancer Patients with Superior Vena Cava Invasion?",
abstract = "PURPOSE: The purpose of this study is to explore the possibility of surgery after chemoradiotherapy (CRT) for locally advanced-non-small-cell lung cancer (LA-NSCLC) with superior vena cava (SVC) resection in terms of prognosis and early and late postoperative course.METHODS: The medical records of NSCLC patients who underwent surgery after CRT at our institution between January 2001 and March 2016 were reviewed. We evaluated the feasibility of surgery with SVC resection after CRT.RESULTS: A total of 8 LA-NSCLC patients were enrolled in this study. The SVC management included a graft replacement in two patients, pericardial patch repair in two, and direct suture closure in four. A complete resection was achieved in seven of the eight patients (87.5{\%}). Postoperative early and late complication rate (Clavien-Dindo classification ≥ grade III) was 25{\%}. All the complications were manageable, and no treatment-related deaths occurred in this series. Although seven out of eight patients showed good patency of reconstructed SVC, one patient exhibited the SVC occlusion during long-term follow-up period. Regarding the prognosis, the 5-year overall survival (OS) rate was 60.0{\%}, and the 2-year recurrence-free survival (RFS) rate was 75.0{\%}.CONCLUSION: Our results suggest that surgery with SVC resection after CRT is a feasible procedure in terms of clinical outcomes and postoperative course.",
keywords = "chemoradiotherapy, non-small-cell lung cancer, superior vena cava",
author = "Hiroki Sato and Junichi Sou and Katsuyuki Hotta and Kuniaki Katsui and Susumu Kanazawa and Katsuyuki Kiura and Shinichi Toyooka",
year = "2018",
month = "6",
day = "20",
doi = "10.5761/atcs.oa.18-00027",
language = "English",
volume = "24",
pages = "131--138",
journal = "Annals of Thoracic and Cardiovascular Surgery",
issn = "1341-1098",
publisher = "Japanese Association for Coronary Artery Surgery",
number = "3",

}

TY - JOUR

T1 - Is Surgery after Chemoradiotherapy Feasible in Lung Cancer Patients with Superior Vena Cava Invasion?

AU - Sato, Hiroki

AU - Sou, Junichi

AU - Hotta, Katsuyuki

AU - Katsui, Kuniaki

AU - Kanazawa, Susumu

AU - Kiura, Katsuyuki

AU - Toyooka, Shinichi

PY - 2018/6/20

Y1 - 2018/6/20

N2 - PURPOSE: The purpose of this study is to explore the possibility of surgery after chemoradiotherapy (CRT) for locally advanced-non-small-cell lung cancer (LA-NSCLC) with superior vena cava (SVC) resection in terms of prognosis and early and late postoperative course.METHODS: The medical records of NSCLC patients who underwent surgery after CRT at our institution between January 2001 and March 2016 were reviewed. We evaluated the feasibility of surgery with SVC resection after CRT.RESULTS: A total of 8 LA-NSCLC patients were enrolled in this study. The SVC management included a graft replacement in two patients, pericardial patch repair in two, and direct suture closure in four. A complete resection was achieved in seven of the eight patients (87.5%). Postoperative early and late complication rate (Clavien-Dindo classification ≥ grade III) was 25%. All the complications were manageable, and no treatment-related deaths occurred in this series. Although seven out of eight patients showed good patency of reconstructed SVC, one patient exhibited the SVC occlusion during long-term follow-up period. Regarding the prognosis, the 5-year overall survival (OS) rate was 60.0%, and the 2-year recurrence-free survival (RFS) rate was 75.0%.CONCLUSION: Our results suggest that surgery with SVC resection after CRT is a feasible procedure in terms of clinical outcomes and postoperative course.

AB - PURPOSE: The purpose of this study is to explore the possibility of surgery after chemoradiotherapy (CRT) for locally advanced-non-small-cell lung cancer (LA-NSCLC) with superior vena cava (SVC) resection in terms of prognosis and early and late postoperative course.METHODS: The medical records of NSCLC patients who underwent surgery after CRT at our institution between January 2001 and March 2016 were reviewed. We evaluated the feasibility of surgery with SVC resection after CRT.RESULTS: A total of 8 LA-NSCLC patients were enrolled in this study. The SVC management included a graft replacement in two patients, pericardial patch repair in two, and direct suture closure in four. A complete resection was achieved in seven of the eight patients (87.5%). Postoperative early and late complication rate (Clavien-Dindo classification ≥ grade III) was 25%. All the complications were manageable, and no treatment-related deaths occurred in this series. Although seven out of eight patients showed good patency of reconstructed SVC, one patient exhibited the SVC occlusion during long-term follow-up period. Regarding the prognosis, the 5-year overall survival (OS) rate was 60.0%, and the 2-year recurrence-free survival (RFS) rate was 75.0%.CONCLUSION: Our results suggest that surgery with SVC resection after CRT is a feasible procedure in terms of clinical outcomes and postoperative course.

KW - chemoradiotherapy

KW - non-small-cell lung cancer

KW - superior vena cava

UR - http://www.scopus.com/inward/record.url?scp=85055607374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055607374&partnerID=8YFLogxK

U2 - 10.5761/atcs.oa.18-00027

DO - 10.5761/atcs.oa.18-00027

M3 - Article

VL - 24

SP - 131

EP - 138

JO - Annals of Thoracic and Cardiovascular Surgery

JF - Annals of Thoracic and Cardiovascular Surgery

SN - 1341-1098

IS - 3

ER -