Standard versus extended pneumonectomy for lung cancer: what really matters?

Subotic, Dragan; Savić, Milan; Atanasijadis, Nikola; Gajić, Milan; Stojšić, Jelena; Popović, Marko; Milenkovic, Vladimir M.; Garabinovic, Zeljko

doi:10.1186/1477-7819-12-248

Cited by 2 publications

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“…Mediastinal downstaging occurred in 48% of patients with trimodality treatment, but only 15% had a pathological CR. Multivariate analysis revealed that three factors were associated with improved outcome: lobectomy, pathological downstaging, and completeness of resection …”

Section: Discussionmentioning

confidence: 99%

“…Multivariate analysis revealed that three factors were associated with improved outcome: lobectomy, pathological downstaging, and completeness of resection. 9,11,[24][25][26][27][28][29][30][31][32][33] Hence, both trials showed equivalence in OS between surgery and thoracic radiotherapy and better local control with surgery than radiotherapy. Exploratory subgroup analyses of both trials showed an improved outcome in patients who are downstaged and/or in whom a complete resection could be obtained with lobectomy.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

et al. 2017

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BackgroundIn spite of the progress made in neoadjuvant therapy for operable non small‐cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA.MethodsRetrospective data of 163 patients diagnosed with stage IIIA NSCLC after surgery was analyzed. The patients were divided into two groups: a preoperative chemotherapy group including 59 patients who received platinum‐etoposide doublet treatment before surgery, and an upfront surgery group including 104 patients for whom surgical resection was the first treatment step. Adjuvant chemotherapy or/and radiotherapy was administered to 139 patients (85.3%), while 24 patients (14.7%) were followed‐up only.ResultsThe rate of N2 disease was significantly higher in the upfront surgery group (P < 0.001). The one‐year relapse rate was 49.5% in the preoperative chemotherapy group compared to 65.4% in the upfront surgery group. There was a significant difference in relapse rate in relation to adjuvant chemotheraphy treatment (P = 0.007). The probability of relapse was equal whether radiotherapy was applied or not (P = 0.142). There was no statistically significant difference in two‐year mortality (P = 0.577). The median survival duration after two years of follow‐up was 19.6 months in the preoperative chemotherapy group versus 18.8 months in the upfront surgery group (P = 0.608 > 0.05).ConclusionThere was significant difference in preoperative chemotherapy group regarding relapse rate and treatment outcomes related to the lymph node status comparing to the upfront surgery group. Neoadjuvant/adjuvant chemo‐therapy is a part of treatment for patients with stage IIIA NSCLC, but further investigation is required to determine optimal treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

et al. 2017

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Case report of cardiac herniation after sleeve pneumonectomy with superior vena cava reconstruction

Fukui

Suzuki

Koyanagi

et al. 2018

Gen Thorac Cardiovasc Surg

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Cardiac herniation is a complication that occurs after intrapericardial pneumonectomy. It is life-threatening unless promptly diagnosed and surgery performed. We report a case of cardiac herniation after right intrapericardial pneumonectomy following radiotherapy for lung cancer. The patient developed cardiac herniation with sudden hypotension following a switch to the spine position. An immediate switch to the lateral decubitus position improved the cardiocirculatory dynamics, and surgical patch closure was performed. The circulation dynamics was unstable for several hours after surgery with elevated enzyme levels, which improved 2 days later. Immediate thoracotomy before irreversible myocardial damage resulted in a successful outcome. The risk of cardiac herniation should always be considered after intrapericardial pneumonectomy.

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Standard versus extended pneumonectomy for lung cancer: what really matters?

Abstract: Background: It is still not clear whether an intrapericardial pneumonectomy indicates a more advanced stage of the disease compared to a standard pneumonectomy.

Cited by 2 publications

References 25 publications

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

Case report of cardiac herniation after sleeve pneumonectomy with superior vena cava reconstruction

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