IntroductionThe surgical treatment of non-small cell lung cancer (NSCLC) with synchronous brain matastases is more effective than other therapeutic options, but this management is still controversial.The aim of the studyThe aim of the study was to evaluate the survival of patients after pulmonary resection NSCLC preceded by resection of brain metastases.Material and methodsFrom 2007 to 2012, 645 patients underwent pulmonary resection for NSCLC at our department. In 25 of them (3.87%) thoracic surgery was preceded by resection of a single brain metastasis of NSCLC and a PET CT scan. No signs of nodal involvement or distant metastases were detected.ResultsThe group consisted of 18 men (72%) and 7 women (28%). Average age was 57.62 years (46-70). In all cases, whole brain radiotherapy (5 × 4 Gy) was performed. The average interval between excision of brain metastasis and lung resection was 31.4 days (27-41). Pneumonectomy was performed in 1, lobectomy/bilobectomy in 17 and wedge resection in 7 cases. Pathological stage N0 was diagnosed in 17, N1 in 5 and N2 in 3 patients. Average survival was 18.68 months (4-74). Survival at 1, 2 and 5 years was 64%, 28% and 28% respectively. Average disease-free survival was 17.52 months. Histological type (p = 0.57) and G (p = 0.82) have no influence on survival. All the patients with hilar lymph node involvement died within 26 months and with mediastinal one within 12 months.ConclusionsSurgical treatment of patients with NSCLC with synchronous brain metastases may prove beneficial in selected patients after excluding other distant metastases and lymph node involvement.
Background: Uniportal video-assisted thoracoscopic surgery (VATS) is a challenging surgical procedure that poses substantial technical difficulties compared to multiportal VATS but has been associated with favorable outcomes in studies reported to date. Methods: On-line databases were screened until June 2016. Meta-analysis aimed to compare clinical outcomes of uniportal and multiportal VATS lobectomy for patients with lung cancer. Endpoints assessed included perioperative mortality, operative time and blood loss; length of hospital stay; duration of postoperative drainage; rates of conversion to open thoracotomy; number of harvested lymph nodes and overall morbidity. Risk Ratios (RR)/ Mean Difference (MD) and corresponding 95% Confidence Intervals (95%CIs) served as primary statistics.
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