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
N1 - Publisher Copyright:
© 2018 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery.
PY - 2018
Y1 - 2018
N2 - Purpose: The purpose of this study is to explore the possibility of surgery after chemoradio-therapy (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 chemoradio-therapy (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
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U2 - 10.5761/ATCS.OA.18-00027
DO - 10.5761/ATCS.OA.18-00027
M3 - Article
C2 - 29681596
AN - SCOPUS:85055607374
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 -