Original articleGeneral thoracicLong-Term Outcomes of En Bloc Resection of Non-Small Cell Lung Cancer Invading the Thoracic Inlet and Spine
Section snippets
Patients
Between January 1992 and December 2009, 54 consecutive patients underwent en bloc resection with curative intent for NSCLC invading the TI and spine, at the Department of Thoracic Surgery, Marie Lannelongue Hospital, France. Our Institutional Review Board approved this retrospective study and waived the need for informed consent.
Inclusion criteria were histologically documented NSCLC and invasion of the first rib and spine and (or) IF suggested by the preoperative investigations and confirmed
Results
There were 36 men and 18 women with a mean age of 52 years (range, 37 to 71 years). Serum carcinoembryonic antigen was elevated in 12 patients, normal in 32, and unknown in 10. Induction treatment was given to 27 (50%) patients and consisted of platinum-based chemotherapy alone (n = 24) or with radiation in a mean dose of 35 Gy (range, 30 to 45 Gy) (n = 3).
The tumor was on the right side in 31 (57%) patients and on the left side in 23 (43%). Spinal resection involved 2 levels in 5 (9%) patients
Comment
We previously reported a preliminary study in 17 patients that aimed to describe a new combined surgical approach for en bloc resection of NSCLC invading the TI and spine [1]. The current study is an extension of our experience and includes a larger number of patients with longer follow-ups. It clearly confirms the safety and efficacy of our combined anterior transcervical and posterior midline approach for complete en bloc resection of NSCLC invading both the TI and the spine. Although
References (13)
- et al.
En bloc resection of non-small cell lung cancer invading the thoracic inlet and intervertebral foramina
J Thorac Cardiovasc Surg
(2002) - et al.
Radical en bloc resection for lung cancer invading the spine
J Thorac Cardiovasc Surg
(2002) - et al.
Superior sulcus tumors with vertebral body involvement: a multimodality approach
J Thorac Cardiovasc Surg
(2009) - et al.
Influence of surgical resection and brachytherapy in the management of superior sulcus tumor
Ann Thorac Surg
(1994) - et al.
Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet
J Thorac Cardiovasc Surg
(1993) - et al.
Management of tumor adherent to the vertebral column
J Thorac Cardiovasc Surg
(1989)