Original ArticlesExtended resections for bronchogenic carcinoma invading the superior vena cava system
Section snippets
Material and methods
From January 1983 to June 1996, 25 consecutive patients with NSCLC invading the SVC system were operated on. Only patients with direct involvement of the SVC system by the tumor were considered for surgical resection, whereas patients with SVC involvement related to bulky N2 disease were not considered for resection.
There were 22 men and 3 women with a mean age of 59 years, ranging from 36 to 77 years.
Eligibility for SVC system resection included: (1) histologically proven invasion of the SVC
Results
The follow-up was complete for all but 1 patient, who was untraceable after 6 months of follow-up.
Five patients had neoadjuvant treatment (chemotherapy in 4 patients, radiotherapy in 1 patient) while the others were operated on before any medical treatment.
Comment
Tumor involvement of the SVC system can occur either by direct extension of the primary tumor (T4) or by invasion of bulky mediastinal adenomegaly (N2) 1, 2, 4; moreover, often, bulky lung cancer involves other mediastinal structures such as carina, left atrium, or both. Thus, the unresectability of a lung cancer invading the SVC system may be technical (direct tumor invasion of other mediastinal structures) or/and oncologic due to the presence of bulky N2 disease. However, in some cases, SVC
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