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Z. Perduka
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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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P2.03-010 - Sleeve, Semsleeve Lobectomy, Segment Pyramidobasalectomy in Patients with Preoperative Contraindication for Pneumonectomy (ID 2429)
09:30 - 09:30 | Author(s): Z. Perduka
- Abstract
Background:
Sleeve and semisleeve lobectomy and segment pyramydobasalectomy is a parenchyma-sparing procedure that is particularly valuable in patients with cardiac or pulmonary contraindications to pneumonectomy. The purpose of this study is to report our experience with sleeve lobectomy for bronchogenic cancer and carcinoid , and to investigate factors associated with long-term survival.
Methods:
Between January 2006 and Novembre 2014,19 patients were treated by saving lung parencima. Patients underwent sleeve lobectomy for non-small-cell lung cancer (n = 3) one patient underwent double sleeve lobectomy or carcinoid tumor (n = 15), including 5 patients underwent sleeve lobectomy (atipic carcinoid) and 10 patients underwent semisleeve lobectomy (tipic carcinois) with a preoperative contraindication to pneumonectomy. Mean age was 52 ± 14 years (range, 19 to 79 years). Vascular sleeve resection was performed in 1 patient and segmentbasalectomy on the right lung.
Results:
Major bronchial anastomotic complications occurred in 2 (13%) patient: One was fatal postoperatively(double sleeve bronchial and vasculare) two weeks after intervent ,because was massive hemoptisia , and one after pyramidbazalectomy 6-th day after intervent because nosocomial difusse pneumonia in the rest lung(shock septic). In the non-small-cell lung cancer group, operative mortality was 13% (2 of 15), and overall 5-year and 10-year survival rates were 60% . By multivariate analysis, two factors significantly and independently influenced survival: nodal status (N0 or N1 versus N2; p = 0.01) and microscopic invasion of the bronchial stump (p = 0.02). In the carcinoid tumor group, there were no operative deaths, and overall 5-year and 10-year survival rates were 100% and 95%, respectively.
Conclusion:
Sleeve lobectomy achieves local tumor control and is associated with low mortality and bronchial anastomotic complication rates. Long-term survival is excellent for carcinoid tumors. For patients with non-small-cell lung cancer, N2 disease or incomplete resection is associated with a worse prognosis; outcome is not affected by presence of a preoperative contraindication to pneumonectomy.Sleeve lobectomy facilitated the maintenance of residual lung function without serious perioperative complications. This finding suggests that patients with direct tumor invasion to the bronchus might be good candidates for a sleeve lobectomy, but not those with extra-nodal invasion.
