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P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.03-005 - Bilobectomy for Lung Cancer: Postoperative Results, and Long-Term Outcomes (ID 3124)
09:30 - 17:00 | Author(s): A. Nasar
Bilobectomy for treatment of lung cancer is considered a high-risk procedure as it is associated with increased postoperative complication rate and the negative impact on survival. We analyzed the safety and the oncologic results of this procedure.
We retrospectively reviewed a prospectively collected database to retrieve patients who underwent bilobectomy for lung cancer between 1991 and 2015. Age, gender, neoadjuvant treatment, bilobectomy type and indication, complications, pathology, stage, and survival were analyzed using Cox regression in univariate and multivariate analysis. Kaplan–Meier survival curves were obtained and compared by log–rank.
From our 4144 resected lung cancer cases, bilobectomy was performed on 106(2.5%) patients (55 men; mean age, 65.5 years). There were 51 upper-middle and 55 middle-lower bilobectomies (adenocarcinoma,67 (63.3%); squamous cell carcinoma,35(33%); carcinoid tumor,4(3.8%)). Indications were tumor invasion of the bronchus intermedius in 58 (54.7%), vascular invasion in 26 (24.5%), and tumor crossing the fissure in 22 (20.8%) patients. Induction therapy was performed in 24 patients (24.5%). Thirty-day mortality was 1.89% (n = 2). Overall major morbidity occurred in 13 patients ( 12.3%) among them 9 patients(69.2%) had pulmonary complications . Overall 3 and 5-year survivals were 64.5% and 56.2% respectively. Disease free 3 and 5-year survivals were 47.4% and 43.8% respectively. Significant decrease in 5 year survival was observed among smoker (p=0.046), higher tumor grades (Grade3 versus 1or2 (p=<0.005)), higher stages (stage I, 66.6%; stage II, 51.5%; stage III, 31.2%; p = 0.012)(see Figure) and the nodal(N) disease s (N0, 58.2%; N1and 2, 38.1%; p = 0.054) adversely influenced survival. Multivariate analysis demonstrated that a higher tumor grade (p = 0.005), a larger tumor (p=0.019), advanced N status (p=0.085) and smoking (p=0.056) adversely affecting prognosis. Figure 1
Bilobectomy is associated with a low mortality and an acceptable morbidity. Survival relates to disease stage and N factor. Optimal prognosis is obtained in patients with early stage, low grade tumors and nonsmoker.
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