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T. Oto

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-031 - Feasibility of Median Sternotomy Approach for Locally Advanced Lung Cancer (ID 2126)

      09:30 - 17:00  |  Author(s): T. Oto

      • Abstract

      Trimodality therapy is one of therapeutic options for local advanced lung cancer. While a posterolateral thoracotomy was used as the standard approach, a median sternotomy with or without transverse thoracotomy is applied if necessary. In our institution, we have applied median approach for patients who need dissection of contralateral mediastinal lymph nodes or clamp of great vessels, mainly pulmonary artery, for a safe resection. The purpose of this study was to evaluate the feasibility and clinical outcome of median sternotomy approach for locally advanced lung cancer after chemoradiotherapy.

      Between March 2002 and December 2014, 35 non-small-cell lung cancer patients underwent radical surgery with median sternotomy approach after induction chemoradiotherapy . The medical records were reviewed to investigate clinical outcomes including perioperative complications.

      The median patient age was 59 years (range: 41–77 years). There were 28 men and 7 women in the series. The histological subtype was adenocarcinoma in 21 patients, squamous cell carcinoma in 14. 16 patients had stage IIIA disease, and 19 had stage IIIB disease. The median postoperative hospital stay was 23 days. As notable perioperative complications, 12 patients revealed tachycardia that needs medication, 6 pneumonia, 3 radiation-induced pneumonitis, one wound ablation, one bronchial stump fistula, and one chylothorax. All of them were manageable. There was no treatment-related death in this cohort. As patients’ survival, the 3-year and 5-year overall survival rates were 77.7 % and 67.1 %, respectively. The 1-year and 3-year recurrence-free survival rates were 75.4 % and 63.4 %, respectively.

      Our experience indicates that median sternotomy approach for locally advanced lung cancer after ChRT is feasible procedure after chemoradiotherapy.