Combined Resection of Great Vessels or the Heart for Non-Small Lung Cancer

Abstract

Objectives: The surgical indications for non-small cell lung cancer (NSCLC) infiltrating a great vessel or the heart are controversial. We assessed clinical features and surgical outcomes of patients with non-small cell lung cancer who underwent combined resection of a lung and great vessel. Methods: Fourteen patients underwent great vessel resection under a lobectomy (n = 9), sleeve lobectomy (n = 2), or pneumonectomy (n = 3) between 2000 and 2011, in whom the aorta was resected in 6, superior vena cava in 5, right atrium in 1, and left atrium in 2. The histological types were adenocarcinoma (n = 8) and squamous cell carcinoma (n = 6). Results: Complete resection was performed in 12 patients. Of all patients, 7 had pN0 disease, 2 had pN1, and 4 had pN2. The postoperative morbidity rate was 28.6% and mortality rate was 7.1%. The 5-year survival rate was 26.8% for all patients, 46.9% for those with an adenocarcinoma, 0% for those with a squamous cell carcinoma, 53.6% for those with pN0, and 0% for those with pN1-2. Conclusion: Resection of the great vessels and heart involved by NSCLC can be performed with acceptable morbidity and mortality, and results in prolonged survival in patients, with an adenocarcinoma or N0 status.

Extended pneumonectomy for advanced lung cancer with cardiovascular structural invasions

“…Between 2000 and 2016, 22 articles on the subject of extended pneumonectomy were collected, [1,5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] including 14 (63.6%) original articles and eight (36.3%) case reports, with a total of 619 patients involved. In 21 reports, patients' age was reported with a median age of 69 years (range, 18-81 years).…”

“…Clinical N status (N 0 /N 1 /N 2 ) was reported in 19 reports [1,5,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] for 112 patients: N 0 (n=26, 23.3%), N 1 (n=19, 17.0%), N 0 / 1 (n=35, 31.3%), and N 2 (n=32, 28.6%). There were more cases with N 0 or N 1 than those with N 2 (c 2 =41.1, p<0.001).…”

“…A total of 180 patients received adjuvant preoperative radio-and (or) chemotherapy: 156 (86.7%) were chemo, four (2.2%) were radio-and Patients were under follow-up for 22.5±10.5 (range, 8-43; median, 19) months (n=17). [5,[9][10][11][13][14][15][16][17][18][19][20][21][22][23][24]26] During the follow-up period, the number of deceased patients was reported in nine reports, which amounted up to 156 cases with a mortality of 25.2%. [1,[9][10][11][12][13][14][15][17][18][19][20][21][22]24,26] Postoperative reoccurrence and metastasis were seen in 14 [10,14,17] and 30 cases, [9,18] respectively.…”

Superior vena cava replacement combined with venovenous shunt for lung cancer and thymoma: a case series

“…However, there were no postoperative deaths or major complications. Therefore, SVC replacement combined with VVS is technically feasible, and has an acceptable perioperative risk (3,6,13,19).…”

Left atrial rupture during right-sided combined pneumonectomy for cancer

“…При этом, несмотря на развитие торакальной хирургии, анестезиологии и реаниматологии, сохраняется относительно высокая частота послеоперационных осложнений и летальность. По разным публикациям [5,[9][10][11]16], эти показатели широко варьируют -от 20 до 52,6% и от 9 до 10,5% соответственно. Целесообразность таких операций длительное время оставалась дисскутабельной.…”