Long-term results of sleeve lobectomy for lung cancer

Tronc, François; Grégoire, Jocelyn; Rouleau, Jacques R.; Deslauriers, Jean

doi:10.1016/s1010-7940(00)00405-x

Cited by 86 publications

(77 citation statements)

References 21 publications

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“…The inferior pulmonary ligament is usually released at the beginning of the operation. In our experience and agree with others (22,29), hilar mobilization is also important to further minimize the tension at the anastomotic site by completely releasing pericardial tissue. In addition, when upper SL was performed, more attention should be paid to avoid unnecessary bronchial preservation.…”

Section: Discussionsupporting

confidence: 91%

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For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

Ma¹,

Guo²,

Shu³

et al. 2016

J. Thorac. Dis.

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Background: Pneumonectomy (PN) has traditionally been the treatment of choice for central lung tumors for which the alternative is sleeve lobectomy (SL). The aim of this study was to compare early and long-term results after SL and PN in focusing on T3 central non-small cell lung cancer (NSCLC). Methods:Patients who underwent SL (n=58) or PN (n=42) were retrospectively analyzed. For bias reduction, these 100 patients had been selected according to the following criteria: (I) tumor located in the main bronchus less than 2 cm distal to the carina; (II) there were no N2 disease; (III) no induction therapy was applied; (IV) complete resection (R0) was achieved. It is an adequate oncologic resection and should be treated as the first line intervention whenever complete resection can be achieved.

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Section: Discussionsupporting

confidence: 91%

“…SL has evolved from an alternative to PN for patients with compromised lung function, to a standard procedure in selected patients with centrally located advanced NSCLC (4,5,22). Overall survival following SL for patients with NSCLC ranges from 39-53% at five years and 28-34% at ten years (4,5,12,16,18,19,23).…”

Section: Discussionmentioning

confidence: 99%

For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

Ma¹,

Guo²,

Shu³

et al. 2016

J. Thorac. Dis.

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“…When analyzing survival data reported in the literature in the last 15 years, most studies show similar or better results for parenchymal sparing resections if compared with PN (15)(16)(17). Moreover, in the analysis of 5-year survival according to stage and nodal status, SL results in higher survival rates for stages I, II.…”

Section: Analysis Of Resultsmentioning

confidence: 95%

Current Role of Bronchoplastic Procedure for Lung Cancer

D’Andrilli¹,

Maurizi²,

Venuta³

et al. 2012

Toraks Cer Bult

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The indication for a sleeve resection is well established: a tumor arising at the origin of a lobar bronchus but not infiltrating as far as to require pneumonectomy. In addition, a sleeve resection may be indicated when N1 nodes infiltrate the bronchus from the outside, as is often the case in the left upper lobe tumors. From a functional point of view, sleeve lobectomy is strictly indicated in patients who cannot withstand pneumonectomy, but recent experiences have shown that the advantages of sparing lung parenchyma are evident also in patients without cardio-pulmonary impairment. Most studies show similar or better survival results for parenchymal sparing resections if compared with pneumonectomy. Moreover, in the analysis of 5-year survival according to stage, sleeve lobectomy results in higher survival rates for stage I, II. The survival advantage in stage III appears to be limited and the benefit is not always confirmed for stage III-N2 patients. Postoperative morbidity and mortality data reveal overall better results for patients undergoing sleeve lobectomy with respect to pneumonectomy. The preservation of lung parenchyma has been indicated by some authors as the possible cause of a theoretical increased risk for locoregional recurrence after sleeve lobectomy. However, although in some experiences a higher local recurrence rate is reported for sleeve resection with advanced nodal status (N2), the few studies analysing risk factors for recurrence, show that the tumor stage and the nodal status are the only negative predictive factors, rather than the type of operation performed.

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“…Many studies have now clearly shown that, when feasible, sleeve resections are valid alternatives to pneumonectomy as they result in lower perioperative mortality and better mid-term survival with excellent long-term outcomes [44][45][46]. Sleeve resections can involve the bronchial tree only or the ipsilateral pulmonary artery as well (''double sleeve or bronchovascular resection'') [45,47].…”

Section: Types Of Procedures and Approachesmentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Long-term results of sleeve lobectomy for lung cancer

Abstract: Sleeve lobectomy is a safe and effective therapy for patients with resectable lung cancer. The presence of N1 and N2 disease, or of non-squamous carcinoma significantly worsen the prognosis.

Cited by 86 publications

References 21 publications

For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

Current Role of Bronchoplastic Procedure for Lung Cancer

Surgery for nonsmall cell lung cancer

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