Salvage surgery after chemotherapy and/or radiotherapy including SBRT and proton therapy : A consecutive analysis of 38 patients

Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved..

BACKGROUND: Local recurrence after definitive chemoradiation therapy, chemotherapy or radiotherapy with curative intent is often seen in patients with advanced non-small cell lung cancer. We evaluated the feasibility of salvage pulmonary resection after definitive non-surgical treatments and the postoperative morbidity and mortality rates.

METHODS: We retrospectively analyzed the characteristics and medical courses of patients who had undergone salvage pulmonary resections after local relapse or progression between January 2000 and March 2018 at the National Cancer Centre Hospital, Tokyo, Japan. All the candidates were evaluated, and curability by surgical resection was assessed by a multidisciplinary tumor board.

RESULTS: A total of 38 patient received salvage surgery: 26 of the patients were men, and the median age was 64.5 years (range, 20-78 years). Among these 38 patients, salvage lung resection was performed after chemoradiotherapy in 23 patients, after chemotherapy in 9 patients, and after radiotherapy with curative intent in 6 patients. The surgical resection methods were as follows: 26 lobectomies (2 bilobectomy, 15 right upper, 5 right lower, 1 right middle, 2 left lower and 1 left upper), 8 pneumonectomies (5 left and 3 right), and 4 segmentectomies. A complete resection (R0 resection) was achieved in 35 cases (92.1 %). Postoperative complications were observed in 3 patients (prolonged air leakage, bronchopleural fistula and surgical site infection in 1 patient each). No postoperative deaths occurred within 30 days after surgery.

CONCLUSION: Along with better outcomes after definitive chemoradiotherapy, chemotherapy, and radiotherapy, the frequency of salvage surgery has been increasing in recent years. Salvage pulmonary resections after definitive non-surgical treatments with curative intent are feasible with an acceptable morbidity rate and oncological outcomes in thoroughly assessed patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:145

Enthalten in:

Lung cancer (Amsterdam, Netherlands) - 145(2020) vom: 01. Juli, Seite 105-110

Sprache:

Englisch

Beteiligte Personen:

Kobayashi, Aki K [VerfasserIn]
Horinouchi, Hidehito [VerfasserIn]
Nakayama, Yuko [VerfasserIn]
Ohe, Yuichiro [VerfasserIn]
Yotsukura, Masaya [VerfasserIn]
Uchida, Shinsuke [VerfasserIn]
Asakura, Keisuke [VerfasserIn]
Yoshida, Yukihiro [VerfasserIn]
Nakagawa, Kazuo [VerfasserIn]
Watanabe, Shun-Ichi [VerfasserIn]

Links:

Volltext

Themen:

Definitive chemoradiation therapy
Journal Article
Salvage surgery

Anmerkungen:

Date Completed 21.06.2021

Date Revised 21.06.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.lungcan.2020.04.013

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310049458