Outcomes After Resection of T4 Non-Small Cell Lung Cancer Using Cardiopulmonary Bypass

Langer, Nathaniel B.; Mercier, Olaf; Fabre, Dominique; Lawton, James; Mussot, Sacha; Dartevelle, Philippe; Fadel, Élie

doi:10.1016/j.athoracsur.2016.03.044

Cited by 32 publications

(52 citation statements)

References 16 publications

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“…In a case in which a tumor invades a great vessel or LA, CPB is required to achieve complete resection. Although favorable outcomes have been reported many times of using CPB in locally advanced NSCLC [1, 2, 3, 4, 5], CPB can induce immunosuppression and tumor dissemination [2, 3, 6]. Muralidaran and co-workers [7] described poor prognoses in patients when CPB is unplanned.…”

Section: Commentmentioning

confidence: 99%

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Circulating Tumor Cell Count Can Be a Useful Prognostic Factor in Lung Resection via Cardiopulmonary Bypass

et al. 2017

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Tumor resection with cardiopulmonary bypass (CPB) remains controversial in the field of oncology. Here, we present a 57-year-old male patient with locally advanced squamous cell carcinoma. The tumor was located in the left hilum and invaded the left atrium. Complete resection, left pneumonectomy combined with partial left atrium resection, was achieved using CPB. We evaluated the circulating tumor cell (CTC) counts, as a surrogate for micrometastasis, in peripheral blood and the CPB circuit. Both CTC counts were 0, which could indicate local disease without micrometastasis. CTC count may be a useful indicator for tumor resection with CPB in lung cancer.

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Section: Commentmentioning

confidence: 99%

“…In selected patients with locally advanced NSCLC, complete resection using cardiopulmonary bypass (CPB) is sometimes performed. This method may contribute to a favorable prognosis [1, 2, 3, 4, 5]. However, the safety of using CPB is still controversial in the oncology field.…”

Section: Introductionmentioning

confidence: 99%

Circulating Tumor Cell Count Can Be a Useful Prognostic Factor in Lung Resection via Cardiopulmonary Bypass

et al. 2017

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“…Cardiopulmonary bypass (CPB) has been used selectively in the resection of T4 tumors (9–12). Use of CPB was mainly associated with aortic (43%) and left atrium/pulmonary vein resections (24%) (10).…”

Section: Introductionmentioning

confidence: 99%

“…Use of CPB was mainly associated with aortic (43%) and left atrium/pulmonary vein resections (24%) (10). Institutional series reporting CPB were small and found favorable short- and long-term results associated with the use of CPB for NSCLC (9,11); however, a singular national registry study observed unacceptable mortality (>25%) and morbidity (>70%) associated with this procedure (12). All studies noted that unplanned use of CPB owing to vessel injury was associated with inferior overall results, compared with planned use (10,12).…”

Section: Introductionmentioning

confidence: 99%

Initial extended resection or neoadjuvant therapy for T4 non-small cell lung cancer—what is the evidence?

Ilonen

Jones

2018

Shanghai Chest

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Locally advanced non-small cell lung cancer (NSCLC) tumors that invade surrounding structures within the chest (T4) are a heterogeneous group, and, as such, there are no straightforward guidelines for their management. Advances in imaging, invasive mediastinal staging, and neoadjuvant therapies have expanded the role of surgery with curative intent for this patient group and have also diminished the rate of explorative thoracotomies. Unlike for T4 superior sulcus tumors, the use of neoadjuvant therapy for central T4 tumors is not clearly defined. The most important determinants of a successful outcome after surgery are achieving an R0 resection and avoiding incidental pathologic N2 disease. Use of neoadjuvant therapy in this setting may yield better outcomes after surgery, as both of these variables can be altered if the tumor responds to neoadjuvant therapy. Moreover, response to induction therapy has been shown to have prognostic value.

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“…Tertiary referral centres are increasingly undertaking resection of advanced lung and esophageal malignancies as part of multimodal therapy and reporting reasonable survival (49)(50)(51)(52)(53). Resection of lung malignancies with reconstruction of superior or inferior vena cava, left atrium, distal aorta, and carina has been described with VA ECMO support (52) as have esophageal malignancies invading the carina (5).…”

Section: Advanced Surgical Resectionsmentioning

confidence: 99%

Principles and indications of extracorporeal life support in general thoracic surgery

McRae¹,

Perrot²

2018

J. Thorac. Dis.

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The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO 2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA ® Novalung ® , Heilbronn, Germany), and extracorporeal CO 2 removal (ECCO 2 R). The ECMO and Novalung ® devices can be used in different modes for the short term or long-term support depending on the situation. In this review, the principles and current applications of ECLS in general thoracic surgery are presented.

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Outcomes After Resection of T4 Non-Small Cell Lung Cancer Using Cardiopulmonary Bypass

Cited by 32 publications

References 16 publications

Circulating Tumor Cell Count Can Be a Useful Prognostic Factor in Lung Resection via Cardiopulmonary Bypass

Circulating Tumor Cell Count Can Be a Useful Prognostic Factor in Lung Resection via Cardiopulmonary Bypass

Initial extended resection or neoadjuvant therapy for T4 non-small cell lung cancer—what is the evidence?

Principles and indications of extracorporeal life support in general thoracic surgery

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