Risk Associated with Bilobectomy after Neoadjuvant Concurrent Chemoradiotherapy for Stage IIIA‐N2 Non‐small‐cell Lung Cancer

Cho, Jong Ho; Kim, Young Tae; Kim, Kwhanmien; Shim, Young Mog; Kim, Hong Kwan; Choi, Yong Soo

doi:10.1007/s00268-012-1472-9

Cited by 9 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An equally important finding of this analysis is that extended resections were associated with increased mortality, 19% at 30 and 90 days. Excessive mortality following pneumonectomy 6,19 and bilobectomy 26 as part of trimodality therapy has been previously reported. Extended resections did not portend an increased rate of Gr3/4AEs, but when an AE occurred, patients were significantly more likely to die as a result compared with those with AEs following lobectomy.…”

Section: Discussionmentioning

confidence: 99%

Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer

Donington

Paulus

Edelman

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

Objective: Concern exists regarding surgery after thoracic radiation. We aimed to assess early results of anatomic resection following induction therapy with platinum-based chemotherapy and full-dose thoracic radiation for resectable N2þ stage IIIA non-small cell lung cancer. Methods: Two prospective trials were recently conducted by NRG Oncology in patients with resectable N2þ stage IIIA non-small cell lung cancer with the primary end point of mediastinal node sterilization following concurrent full-dose chemoradiotherapy (Radiation Therapy Oncology Group trials 0229 and 0839). All surgeons demonstrated postinduction resection expertise. Induction consisted of weekly carboplatin (area under the curve, 2.0) and paclitaxel (50 mg/m 2) and concurrent thoracic radiation 60 Gy (0839)/61.2 Gy (0229) in 30 fractions. Patients in study 0839 were randomized 2:1 to weekly panitumumab þ chemoradiotherapy or chemoradiotherapy alone during induction. Primary results were similar in all treatment arms and reported previously. Short-term surgical outcomes are reported here. Results: One hundred twenty-six patients enrolled; 93 (74%) had anatomic resection, 77 underwent lobectomy, and 16 underwent extended resection. Microscopically margin-negative resections occurred in 85 (91%). Fourteen (15%) resections were attempted minimally invasively, including 2 converted without event. Grade 3 or 4 surgical adverse events were reported in 26 (28%), 30-day mortality in 4 (4%) and 90-day mortality in 5 (5%). Patients undergoing extended resection experienced similar rates of grade 3 or 4 adverse events (odds ratio, 0.95; 95% confidence interval, 0.42-3.8) but higher 30-day (1.3% vs 18.8%) (odds ratio, 17.54; 95% confidence interval, 1.75-181.8) and 90-day mortality (2.6% vs 18.8%) (odds ratio, 8.65; 95% confidence interval, 1.3-56.9). Conclusions: Lobectomy was performed safely following full-dose concurrent chemoradiotherapy in these multi-institutional prospective trials; however, increased mortality was noted with extended resections.

show abstract

Section: Discussionmentioning

confidence: 99%

Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer

Donington

Paulus

Edelman

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

“…When the pathologic involvement of mediastinal lymph nodes (LNs) is documented prior to surgical resection, both local/distant recurrence and metastasis rates are high with resection alone [4]. Although concurrent chemoradiotherapy (CCRT) with or without surgery has been the most recent management trend for locally advanced NSCLC [5], unfortunately those tumors have a dismal prognosis with a median overall survival (OS) of 25-35 months despite multimodal treatment [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for survival in stage IIIA N2 NSCLC patients treated with neoadjuvant CCRT followed by surgery

Lim

Lee

et al. 2014

Cancer Chemother Pharmacol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most patients with advanced non-small cell lung cancer (NSCLC), suffer disease relapse within three years and less than 10% of patients remain alive after a 5-year interval despite surgery (1,2). Because of poor survival, chemotherapy, radiotherapy and target therapy have been utilized in managing advanced NSCLC (3)(4)(5)(6). From the literature review, neoadjuvant chemotherapy followed by surgical resection has been considered useful in select patients with advanced NSCLC, but the postoperative 5-year survival rates of these patients has ranged from 10% to 36% (1,7,8).…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in non-small cell lung cancer patients who received neoadjuvant therapy and curative resection

Hsieh

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

In conclusion, tumor size greater than 5 cm and total metastatic LN ratio greater than 0.065 could predict the DFS of patients with advanced NSCLC after multimodality therapies followed by surgical resection. Tumor size plays a more important role than total metastatic LN ratio in DFS. Moreover, patients identified with these factors need active post-operation surveillance and additional aggressive adjuvant therapies.

show abstract

Risk Associated with Bilobectomy after Neoadjuvant Concurrent Chemoradiotherapy for Stage IIIA‐N2 Non‐small‐cell Lung Cancer

Cited by 9 publications

References 32 publications

Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer

Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer

Predictive factors for survival in stage IIIA N2 NSCLC patients treated with neoadjuvant CCRT followed by surgery

Prognostic factors in non-small cell lung cancer patients who received neoadjuvant therapy and curative resection

Contact Info

Product

Resources

About