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H. Van Veer



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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-022 - Sleeve Lobectomy Is a Safe and Effective Oncologic Procedure: A Single Center Experience over Three Decades (ID 896)

      09:30 - 17:00  |  Author(s): H. Van Veer

      • Abstract
      • Slides

      Background:
      Sleeve lobectomy is a parenchyma-sparing technique suitable for treating central tumors, avoiding pneumonectomy. The aim of this study was to assess perioperative and long-term survival outcomes in patients treated by sleeve lobectomy.

      Methods:
      Data were analysed from a prospectively collected database. All consecutive cases of sleeve lobectomy/bilobectomy (1985 - 2013) were included. Cox-Regression was used to analyse survival outcomes. There were 300 patients available for analysis. Sleeve lobectomy was performed in 272 patients (RUL:153; RML:5; RLL:1; LUL:83; LLL:30), sleeve bilobectomy in 28 (RUM:17; RLM:11). In most patients a sleeve of the bronchus (n=219) or a reversed sleeve of the bronchus (n=19) was performed. Arterial (n=35) or combined arterial and bronchial sleeve (n=27) resections were less common. The most common operative indication was non-small cell lung cancer (254 cases, 85%), less commonly for carcinoid (n=27), small cell lung cancer (n=6) , pulmonary metastasis (n=9) and 4 others.

      Results:
      Patients were predominantly male (85%) with a mean age of 62.7 years (range 20.1-84.6). Postoperative course was uneventful (Dindo-grade 0/1) in 60%; with minor complications (Dindo-grade 2/3a) in 30% and major complications (Dindo-grade 3b/4) in 7.3%. In hospital mortality (Dindo-grade 5) was 2.7%. Overall median survival was 68 months, with a 5- and 10-year survival of 52.3% and 35.8%. A Cox-Regression model showed five independent prognosticators for survival: asymptomatic at presentation, age, pT, pN and neoadjuvant treatment (see table). Although neoadjuvant treatment showed to be a negative prognosticator for survival, complete responders (n=8 or 14.5% of neoadjuvant treated patients) showed a mean survival of 132 months and a 5-year survival of 80%. Figure 1



      Conclusion:
      Sleeve lobectomy can be safely performed as treatment for centrally-located lung tumours. A single-institution experience over 3 decades demonstrates acceptable morbidity and mortality rates. Overall survival seems to be mainly determined by oncologic variables (TNM-staging factors).

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