Salvage surgery for primary lung cancer after chemotherapy in octogenarians

Hino, Haruaki; Nishimura, Takashi; Usuki, Chiemi; Sazuka, Manami; Ito, Tetsuhide; Seki, Arisa; Nitadori, Jun-ichi; Yamada, Hirokazu; Arai, Tomio; Yamamoto, Hiroshi; Nakajima, Jun

doi:10.1111/1759-7714.12423

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…Salvage surgery already plays a role in the treatment of esophageal cancer, colorectal cancer and other tumors . In recent years, salvage surgery has also been introduced into the treatment strategy of advanced lung cancer after chemotherapy/radiotherapy failure . In a study conducted by Hidetaka et al .…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] In recent years, salvage surgery has also been introduced into the treatment strategy of advanced lung cancer after chemotherapy/radiotherapy failure. [18][19][20][21][22] In a study conducted by Hidetaka et al a complete pathological response was found in nearly half the cases who received salvage surgery after chemotherapy/radiotherapy. 23 However, the role of salvage surgery in patients with advanced lung cancer after targeted therapy has still not been well reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Salvage surgery for advanced non‐small cell lung cancer after targeted therapy: A case series

et al. 2020

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Background Tumor recurrence or residual tumor after targeted therapy is common in patients with advanced non‐small cell lung cancer (NSCLC). There is a lack of high‐level evidence on which type of treatment should be employed for these patients and the role of salvage surgery has not been well reported in the literature. Methods A retrospective analysis of patients who underwent salvage surgery in our center between January 2016 and June 2019 for advanced NSCLC after targeted therapy was performed. Results A total number of nine patients were identified, including five males and four females, with a median age of 56 years (range, 40–65 years), all diagnosed with lung adenocarcinoma stage IIIa–IVb. All patients had received targeted therapy according to individual positive mutation of driver gene(s). Salvage surgery was performed for tumor recurrence or residual tumor after a duration of 2–46 months of targeted therapy. A negative surgical margin was achieved in all cases. Postoperative complication rate was 11.1% (1/9). All patients were alive at the time of this analysis and two patients had disease progression. After a median follow‐up of 17 months (range: 5–44 months), the median event‐free survival and postoperative survival was 14 months (range: 2–44 months) and 17 months (range: 5–44 months) respectively. Conclusions Salvage surgery may be a feasible and promising therapeutic option for tumor recurrence or residual tumor in advanced NSCLC in selective patients after targeted therapy. Key points Salvage surgery is feasible in selected patients with advanced NSCLC and provides promising survival outcomes after targeted therapy failure. Salvage surgery provides precise molecular and pathological information which is most important for subsequent therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Salvage surgery for advanced non‐small cell lung cancer after targeted therapy: A case series

et al. 2020

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Prognostic factors affecting survival in patients with non-small cell lung cancer treated with salvage surgery after drug therapy: a multi-institutional retrospective study

Suzuki,

Asakura,

Okui

et al. 2023

World J Surg Onc

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Background The prevalence of salvage surgeries after drug therapy for non-small cell lung cancer (NSCLC) has risen, mainly due to recent progress in molecular-targeted drugs and immune checkpoint inhibitors for NSCLC. While the safety and effectiveness of salvage surgery after drug therapy for NSCLC have been studied, its indications remain unclear. We aimed to identify the prognostic factors affecting survival in patients with advanced-stage (stages III–IV) NSCLC treated with salvage surgery after drug therapy. Methods A retrospective investigation was conducted on patients who received salvage surgery after drug therapy at four hospitals between 2007 and 2020. Salvage surgery was defined as surgery after drug therapy for local progression, tumor conversion to resectable status, and discontinuation of prior drug therapy owing to serious complications. Results Thirty-two patients received cytotoxic agents alone (n = 12 [38%]), tyrosine kinase inhibitors (TKIs; n = 16 [50%]), or immune checkpoint inhibitors (n = 4 [13%]) as prior drug therapy. In 11 (34%) and 21 (66%) patients, the clinical stage before treatment was III or IV, respectively. The median initial and preoperative serum carcinoembryonic antigen (CEA) levels were 10.2 (range, 0.5–1024) ng/mL and 4.2 (range, 0.6–92.5) ng/mL, respectively. Among the patients, 28 (88%) underwent lobectomy, 2 (6%) underwent segmentectomy, and 2 (6%) underwent wedge resection. Complete resection of the primary lesion was accomplished in 28 (88%) patients. Postoperative complications were documented in six (19%) patients. Mortality rates were 0% at 30 days and 3% at 90 days post-operation. The 5-year overall survival rate stood at 66%, while the 5-year progression-free survival rate was 21%. Multivariate analyses showed that prior TKI therapy and preoperative serum CEA level < 5 ng/mL were prognostic factors influencing overall survival (hazard ratio [95% confidence interval]: 0.06 [0.006–0.68] and 0.03 [0.002–0.41], respectively). The 5-year overall survival in the 11 patients with both favorable prognosticators was 100%. Conclusions In this study, prior TKI therapy and preoperative serum CEA level < 5 ng/mL were favorable prognostic factors for overall survival in patients with NSCLC treated with salvage surgery. Patients with these prognostic factors are considered good candidates for salvage surgery after drug therapy.

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Salvage surgery for primary lung cancer after chemotherapy in octogenarians

Cited by 2 publications

References 16 publications

Salvage surgery for advanced non‐small cell lung cancer after targeted therapy: A case series

Salvage surgery for advanced non‐small cell lung cancer after targeted therapy: A case series

Prognostic factors affecting survival in patients with non-small cell lung cancer treated with salvage surgery after drug therapy: a multi-institutional retrospective study

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