En Bloc Resection of Pulmonary Sulcus Non-small Cell Lung Cancer Invading the Spine

Collaud, Stéphane; Fadel, Élie; Schirren, J.; Yokomise, Hiroyasu; Bölükbas, Servet; Dartevelle, Philippe; Keshavjee, Shaf; Waddell, Thomas K.; Perrot, Marc de

doi:10.1097/sla.0000000000000797

Cited by 27 publications

(32 citation statements)

References 13 publications

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“…77 This appears to be far superior to the 26-27% 5-year survival reported in studies reporting intralesional or not en-bloc resection. [77][78][79] The only significant predictor of survival was R0 resection. There was a high rate of R0 resection (89%) compared with 9% R1 (positive microscopic margin) and 2% R2 (positive macroscopic margin).…”

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 75%

“…All 135 patients had en-bloc resection of lung, spine and chest wall. 77 Pooled analysis showed that 5-and 10-year OS were 43% and 26%, respectively. 77 This appears to be far superior to the 26-27% 5-year survival reported in studies reporting intralesional or not en-bloc resection.…”

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

“…77 Pooled analysis showed that 5-and 10-year OS were 43% and 26%, respectively. 77 This appears to be far superior to the 26-27% 5-year survival reported in studies reporting intralesional or not en-bloc resection. [77][78][79] The only significant predictor of survival was R0 resection.…”

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

“…In 2014, Collaud et al published a systematic review and pooled patient analysis on the topic of en-bloc resection of pulmonary sulcus tumours invading the spine. 77 After excluding studies that did not engage in en-bloc resection, they identified 6 independent studies that met their inclusion criteria. 77 Because the authors of only 4 of the 6 studies were able to share updated patient data, Collaud et al included only the 135 patients from those 4 studies in their pooled patient analysis.…”

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

“…77 After excluding studies that did not engage in en-bloc resection, they identified 6 independent studies that met their inclusion criteria. 77 Because the authors of only 4 of the 6 studies were able to share updated patient data, Collaud et al included only the 135 patients from those 4 studies in their pooled patient analysis. Thus, a limitation of this systematic review and pooled analysis is that the patients from the two 'missing' studies may have changed the balance of prognostic factors and thus may have potentially altered the findings of the regression analyses for predictors of survival.…”

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

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MDT lung cancer care: Input from the Surgical Oncologist

2015

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Although there have been many advancements in the multidisciplinary management of non-small cell lung cancer (NSCLC), surgery remains the primary modality of choice for resectable lung cancer when the patient is able to tolerate lung resection physiologically. There have been recent advances in surgical diagnosis and treatment of lung cancer. Increasing use of low-dose computed tomography (CT) screening for lung cancer has resulted in increased detection of small peripheral nodules or semi-solid ground glass opacities. Here, we review different modalities of localization techniques that have been used to aid surgical excisional biopsy when needle biopsy has failed to provide tissue diagnosis. We also report on the current debates regarding the use of sublobar resections for Stage I NSCLC as well as the surgical management of locally advanced NSCLC. Finally, we discuss the complex surgical management of T4 NSCLC lung cancers.

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Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 75%

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

Section: Pulmonary Sulcus Tumours With Spine Invasionmentioning

confidence: 99%

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MDT lung cancer care: Input from the Surgical Oncologist

2015

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Trimodality therapy for Pancoast tumors: T4 is not a contraindication to radical surgery

Waseda

Klikovits

Hoda

et al. 2017

Journal of Surgical Oncology

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Prognostic evaluation of the proposed residual tumor classification in a Chinese non‐small cell lung cancer population

Ren

Sun

Tang

et al. 2022

Journal of Surgical Oncology

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Background This study aimed to validate the R classification including uncertain resection (R‐un) proposed by the International Association for the Study of Lung Cancer (IASLC) in a Chinese non‐small cell lung cancer (NSCLC) population. Methods The study retrospectively investigated a 2009–2013 single‐institutional NSCLC resection cohort in China. After reclassification, recurrence‐free survival (RFS) and overall survival (OS) were calculated using survival analyses and compared with those using the 2005 version IASLC R classification. Results Under the proposed stratification, 3819 (72.1%) individuals were classified as R0, 1371 (25.9%) as R‐un, 71 (1.3%) as R1, and 32 (0.6%) as R2. The 5‐year OS probabilities for the R0, R‐un, and R1/R2 groups were 71%, 46%, and 34%, respectively. The prognostic stratification remained significant in the fully adjusted Cox models (p < 0.001). Compared with the original classification, Harrell's concordance index of reclassification improved significantly, from 0.508 to 0.679 for RFS and from 0.510 to 0.692 for OS (RFS: p = 0.007; OS: p = 0.001). The survival analysis showed that R‐un patients with highest mediastinal lymph node station metastasis had significantly worse survival than R0 patients with mediastinal nodal metastasis (RFS: 44 vs. 36 months, hazard ratio [HR]: 1.29, p < 0.001; OS: 59 vs. 50 months, HR: 1.34, p < 0.001). Cox proportional hazards regression analysis showed that highest mediastinal lymph node station metastasis was an independent risk factor for RFS (HR: 1.22) and OS (HR: 1.25). Conclusions The proposed R classification showed valid prognostic stratification, including highest mediastinal nodal station metastasis.

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En Bloc Resection of Pulmonary Sulcus Non-small Cell Lung Cancer Invading the Spine

Abstract: Multimodality therapy including en bloc resection for pulmonary sulcus NSCLC invading the spine provides excellent long-term survival in selected patients. This result establishes a benchmark against which the effects of new treatments can be compared in the future.

Cited by 27 publications

References 13 publications

MDT lung cancer care: Input from the Surgical Oncologist

MDT lung cancer care: Input from the Surgical Oncologist

Trimodality therapy for Pancoast tumors: T4 is not a contraindication to radical surgery

Prognostic evaluation of the proposed residual tumor classification in a Chinese non‐small cell lung cancer population

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