Long-term survival after lung resection for non–small cell lung cancer with circulatory bypass: A systematic review

Muralidaran, Ashok; Detterbeck, Frank C.; Boffa, Daniel J.; Wang, Zuoheng; Kim, Anthony W.

doi:10.1016/j.jtcvs.2011.07.042

Cited by 52 publications

(56 citation statements)

References 37 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also, combined LC [T4 locally advanced non-small cell lung cancer (NSCLC)] and cardiac surgery under CPB presents tolerable postoperative long-term survival reaching 21.6 months (27). This is in accordance with another study (68) showing 5-year survival for 37% of patients undergoing LC surgery under circulatory bypass. If combined LC and HD surgery, performed under CPB, concerns valvular repair or replacement, then after cardiac operation but before LC resection, the pericardium should be surgically closed to avoid dissemination either of neoplastic cells or infectious micro-organisms of respiratory system origin (13).…”

Section: Discussionsupporting

confidence: 81%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

View full text Add to dashboard Cite

Background: Co-morbidity of primary lung cancer (LC) and heart disease (HD), both requiring surgical therapy, characterizes a high risk group of patients necessitating prompt diagnosis and treatment. The aim of this study is the review of available evidence guiding the management of these patients.Methods: Postoperative outcome of patients operated for primary LC (first meta-analysis) and for both primary LC and HD co-morbidity (second meta-analysis), were studied. Parameters examined in both meta-analyses were thirty-day postoperative mortality, postoperative complications, three-and five-year survival probabilities. The last 36 years were reviewed by using the PubMed data base. Thirty-seven studies were qualified for both meta-analyses. Results:The pooled 30-day mortality percentages (%) were 4.16% [95% confidence interval (CI): 2.68-5.95](first meta-analysis) and 5.26% (95% CI: 3.47-7.62) (second meta-analysis). Higher percentages of squamous histology and lobectomy, were significantly associated with increased (P=0.001) and decreased (P<0.001) thirty-day postoperative mortality, respectively (first meta-analysis). The pooled percentages for postoperative complications were 34.32% (95% CI: 24.59-44.75) (first meta-analysis) and 45.59% (95% CI: 35.62-55.74) (second metaanalysis). Higher percentages of squamous histology (P=0.001), lobectomy (P=0.002) and p-T1 or p-T2 (P=0.034) were associated with higher proportions of postoperative complications (second meta-analysis). The pooled threeand five-year survival probabilities were 68.25% (95% CI: 45.93-86.86) and 52.03% (95% CI: 34.71-69.11), respectively. Higher mean age (P=0.046) and percentage lobectomy (P=0.009) significantly reduced the five-year survival probability.Conclusions: Lobectomy and age were both accompanied by reduced five-year survival rate. Also, combined aorto-coronary bypass grafting (CABG) with lobectomy for squamous pT1 or pT2 LC displayed a higher risk of postoperative complications. Moreover, medical decision between combined or staged surgery is suggested to be individualized based on adequacy of coronary arterial perfusion, age, patient's preoperative performance status (taking into account possible co-morbidities per patient), tumor's staging and extent of lung resection.

show abstract

Section: Discussionsupporting

confidence: 81%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

View full text Add to dashboard Cite

show abstract

“…A recent systematic review of the use of ECC during surgical resection for patients with locally advanced lung cancer yielded only 72 patients (56). They found that extended resections of locally advanced lung cancer is feasible with the help of ECC, although beforehand planning of the use of ECC was associated with significantly higher survival than cases where unplanned or emergent placement of ECC was necessary.…”

Section: Extracorporeal Circulation (Ecc)mentioning

confidence: 99%

Management of large mediastinal masses: surgical and anesthesiological considerations

Li¹,

Boven²,

Annema

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor. A multidisciplinary team should decide whether neoadjuvant therapy can be beneficial. Furthermore, the anesthesiologist has to evaluate the risk of intraoperative mediastinal mass syndrome (MMS). With adequate preoperative team planning, a safe anesthesiological and surgical strategy can be accomplished.

show abstract

“…Although lung cancer with direct invasion into the epicardium or myocardium is considered inoperable by most surgeons, cancer invading the left atrium, aorta, or proximal pulmonary artery can be resected with or without cardiopulmonary bypass [135]. Extracorporeal circulation is well known to cause lung injury and most surgeons use it reluctantly, especially when pneumonectomy is anticipated [136].…”

Section: Resection Of Great Vessels and Heartmentioning

confidence: 99%

“…Extracorporeal circulation is well known to cause lung injury and most surgeons use it reluctantly, especially when pneumonectomy is anticipated [136]. In a recent systematic review of the literature MURALIDARAN et al [135] showed that overall survival at 5-years was 37% in patients undergoing lung cancer resection on circulatory bypass. Survival was significantly higher when placement on bypass was planned preoperatively [135].…”

Section: Resection Of Great Vessels and Heartmentioning

confidence: 99%

“…In a recent systematic review of the literature MURALIDARAN et al [135] showed that overall survival at 5-years was 37% in patients undergoing lung cancer resection on circulatory bypass. Survival was significantly higher when placement on bypass was planned preoperatively [135]. Most series have shown that 30-day mortality was acceptable, even when cardiopulmonary bypass was used [137].…”

Section: Resection Of Great Vessels and Heartmentioning

confidence: 99%

See 1 more Smart Citation

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

View full text Add to dashboard Cite

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

show abstract

Long-term survival after lung resection for non–small cell lung cancer with circulatory bypass: A systematic review

Cited by 52 publications

References 37 publications

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Management of large mediastinal masses: surgical and anesthesiological considerations

Surgery for nonsmall cell lung cancer

Contact Info

Product

Resources

About