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L. Romero Vielva
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-005 - Surgical Resection after Definitive Chemoradiotherapy (ID 782)
09:30 - 09:30 | Author(s): L. Romero Vielva
- Abstract
Background:
Approximately, 30% of non-small-cell lung cancer (NSCLC) patients are diagnosed with locally advanced disease (IIIA-B). Treatment of these patients is controversial, with recommendations including definitive chemoradiotherapy, induction chemotherapy followed by surgery or induction chemoradiotherapy followed by surgical resection. Salvage surgery is defined as resection after high doses of radiation (>50Gy), planned as a primary curative intent, and usually more than 12 weeks after radiotherapy. Lung resection after high-dose radiotherapy has traditionally been avoided due to high rates of morbidity and mortality.
Methods:
The aim of this review is to analyze the outcome of patients referred to our institution for surgical resection after definitive chemoradiation. We reviewed 23 NSCLC patients who underwent surgical treatment after definitive chemoradiation between 2003 and 2014.
Results:
There were 15 men and eight women with a median age of 54.64 years (range 33-69 years). Fifteen patients were diagnosed with adenocarcinoma (65.2%), and the most frequent cTNM stage was T3N2M0 (34.8%) followed by T2N2M0 and T4N2M0. The type of surgical resection included five lobectomies, six bilobectomies and 12 pneumonectomies (seven right and five left pneumonectomies). Four patients showed a complete pathological response after treatment (pT0N0M0 17.4%). There was only one postoperative death due to a bronchopleural fistula. All patients received platinum-based chemotherapy and definitive radiotherapy, with a median dose of 65Gy (range 45-70Gy). Median time from radiotherapy to surgical resection was 8.28 months (0.9-35.47 months). Six patients suffered recurrence after surgery, three to a distant site and three local recurrences. Median disease free survival for the group of patients who relapsed after surgery was 7.7 months (3.9-17.5 months). Figure 1 Median overall survival was 88.3 months (CI 95% 57.6–118.9), with 1, 3 and 5 year survival rates of 87%, 74.5% and 66.3% respectively. Figure 2
Conclusion:
Salvage surgery after definitive chemoradiotherapy is feasible, with low postoperative complication rates and encouraging survival.
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-002 - Risk Factors and Outcomes of Pneumonectomy in Patients with Lung Cancer (ID 2947)
09:30 - 09:30 | Author(s): L. Romero Vielva
- Abstract
Background:
Pneumonectomy has been associated with high morbidity and mortality. The aim of this study is to evaluate complications, risk factors of mortality and overall survival of patients undergoing pneumonectomy for lung cancer.
Methods:
Retrospective study of 380 consecutive patients operated between January 2004 and December 2014. The majority were male (87, 4%), with a mean age of 60.7 years (r: 29-81) and a mean follow-up of 31.7 months.
Results:
Right pneumonectomy was the most frequent procedure (58.2%). Most of the patients were diagnosed with squamous cell carcinoma (56.1%). Half of the patients received neoadjuvant chemotherapy (50.5%) and 18 (4.7%) concomitant radiotherapy. N2 disease was present in 125 patients (32.9%). Figure 1 The most frequent complication was atrial fibrillation (14%). Twenty-seven patients (7.1%) required reoperation for postoperative bleeding. Bronchopleural fistula appeared in 54 patients (14.21%). Twenty-five patients (6.6%) died within 30-days after surgery. Overall survival was 36.6% months with rates at 1, 3 and 5 years of 73.2%, 42.5% and 31,2% respectively. Figure 2 Survival according to tumor size showed significant differences (T1: 33.1 months, T2: 21.1 months, T3: 11.4 months and T4:10.3 months). Survival was lower in patients with N2 disease (10.8 vs 30 months, p=0.0000). Overall survival was higher for left pneumonectomy (17.6 vs 24.8 months).There were significant differences in survival when analyzing lung function parameters, histological type, cancer stage, neoadjuvant treatment, pulmonary or cardiac complications, and reoperation for postoperative bleeding.
Conclusion:
In our series, age, side of resection, lung capacity, tumor extension, extent of surgical resection, comorbidities and postoperative complications are associated with decreased survival.
