Is salvage surgery for recurrent non-small-cell lung cancer after definitive non-operative therapy associated with reasonable survival?: Table 1:

Abstract

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether salvage pulmonary resection is possible and worthwhile for patients with recurrence of non-small-cell lung cancer (NSCLC) after prior definitive non-operative therapy. A total of nine reports were identified using the reported search, of which four represented the best available evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All studies were retrospective. In total, 48 pulmonary salvage resections were performed in 47 patients after prior definitive radiation, chemoradiation or stereotactic body radiation therapy, of which 28 were lobectomies (including 1 sleeve lobectomy), 12 pneumonectomies, 4 bilobectomies and 4 sublobar resections (2 segmentectomies and 2 wedge resections). Postoperative complications ranged from 0 to 58% (mean from four studies 42.5%). Only one study reported any mortality (4%), the other three had zero mortality. Median postoperative survival was reported in two studies and ranged from 9 to 30 months. Experience with salvage lung resection for locally recurrent NSCLC, after prior definitive non-surgical treatment, remains limited. Therefore, this analysis was based on only 48 resections in 47 patients from four retrospective studies. Nevertheless, the published data suggest that salvage lung surgery for recurrent, previously non-operatively managed non-small-cell lung cancer is a worthwhile treatment option with good survival, acceptable morbidity and low mortality.

Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: A case report

“…Recently, salvage surgery is performed more frequently if strict indications are met for treatmentrefractory cases or recurrence after treatment. 1 Van Schil PE presented a series of 19 completion pneumonectomy after bronchial sleeve resection involving recurrent tumor. 2 Although the survival rate was relatively good, the operative mortality rate was 15.8% because of cardiac-related disease and stula of the bronchial stump.…”

“…Recently, salvage surgery is performed more frequently if strict indications are met for treatment of these cases. 1 However, for airway reconstruction surgery on the proximal side, the di culty of securing the airway and vessels more centrally and the effect of prior treatment make the operation more di cult. Herein, we report a case of local recurrent lung cancer after right sleeve upper lobectomy with bronchoplasty and adjuvant chemotherapy, which showed the bene cial effect of right sleeve pneumonectomy at progression after radiotherapy.…”

Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: A case report

“…Recently, salvage surgery is performed more frequently if strict indications are met for treatment-refractory cases or recurrence after treatment. 1 Surgical approach (safe vascular treatment), anastomosis technique (preserving blood supply to the anastomotic site and anastomosis method), and perioperative management (prevention and management for complications) are important aspects of surgery.…”

“…Recently, salvage surgery is performed more frequently if strict indications are met for treatment of these cases. 1 However, for airway reconstruction surgery on the proximal side, the difficulty of securing the airway and vessels more centrally and the effect of prior treatment make the operation more difficult. Herein, we report a case of local recurrent lung cancer after right sleeve upper lobectomy with bronchoplasty and adjuvant chemotherapy, which showed the beneficial effect of right sleeve pneumonectomy at progression after radiotherapy.…”

Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: a case report

“…If such cases relapse unfortunately, they may be treated initially with radiotherapy and/or chemotherapy, but may become recurrent or refractory. Recently, salvage surgery is performed more frequently if strict indications are met for treatment of these cases [1]. However, for airway reconstruction surgery on the proximal side, the difficulty of securing the airway and vessels more centrally and the effect of prior treatment make the operation more difficult.…”