Virtual Library

Start Your Search

Yuho Maki



Author of

  • +

    P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
    • +

      P2.18-03 - Salvage Surgery After Curative-Intent Chemo and/or Radiation for Locally Advanced Lung Cancer (Now Available) (ID 1756)

      10:15 - 18:15  |  Author(s): Yuho Maki

      • Abstract
      • Slides

      Background

      A chemo and/or radiotherapy (CRT) was thought to be the curative treatment for locally advanced lung cancer (LALC) before 2017. However, after the CRT the cancer sometimes remained at the treatment field. The radical pulmonary resection after CRT (Salvage surgery) is the option for the curative treatment. The safety and perioperative complications of salvage surgery after CRT for locally advanced lung cancer have been problematic. Thisa study aimed to identify the long-term survival and the operative results of this kind salvage surgery.

      Method

      The Salvage surgery is defined as resection after platinum based 2-drugs CRT or curative dose radiation therapy for LALC. We retrospectively reviewed our medical records in our institute from January 2008 to March 2019 and collected 33 patients who received salvage surgery. This study was approved by our institutinal review board.

      Result

      The mean age at the surgery was 63 years (range 39~86), with 5 women and 28 men. The initial curative-intent therapy were; concurrent CRT in 26, sequential CRT in 2, and stereotactic body radiotherapy in 5. The mean interval from CRT to the surgery was 31 months (range 3~128). All patients except 2 cases underwent complete surgical resection with mediastinal nodal dissection including lobectomy in 20 cases, lobectomy with bronchoplasty in 2 cases, broncho/ pulmonary angioplasty in 7 cases, pneumonectomy in 2 cases. The bronchial stump was covered with pericardial fat tissue or intercostal muscle. Histological type were adenocarcinoma in 19 cases, squamous carcinoma in 10 cases, large-cell-carcinoma in 2 cases, 1 combined cell small-cell carcinoma, and 1 adenosquamous cell carcinoma. The mean operation time was 302 minutes and mean blood loss was 687g. There was no operative mortality nor in-hospital death. Post-operative complication was seen in 12 cases (36%), however there was no broncho-pleural fistula or bronchial dehiscence. The 3-years and 5-years overall survival after the surgery were 70% and 52.3 % with 53 months median follow-up period. Six years after the salvage surgery, there was no recurrence of lung cancer.

      Conclusion

      The salvage surgery after curative-intent chemotherapy and/or radiotherapy for LALC is feasible with cautious patient selection, careful operative procedure, and meticulous perioperative care. Six years after salvage surgery the survivors may be expected to be free from lung cancer recurrence. iaslc 2019 jpeg.jpg

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.