Author of

• 15301

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  P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Localized Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15329

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    P3.02-028 - miMRST Wedge Resection Cured Aged, Cardiopulmonary Dysfunction Patients with Small Lung Cancer (≤2cm) (ID 1670)

    09:30 - 09:30  |  Author(s): N. Chen
    • Abstract

    Background:
    In China, lung cancer is increasing rapidly. There are more and more aged, cardiopulmonary dysfunction patients were found with peripheral small lung cancer (≤2cm); chemotherapy and radiation are usually denied because of age, cardiopulmonary dysfunction, and fear of the serious side effects of chemo-radiation; surgery was denied because they could not tolerate traditional “large-incision” posterolateral thoracotomy. Video-assisted thoracoscopic surgery (VATS) is good for them; however, most Chinese patients refuse VATS because of the high cost not covered by medical insurance. “miMRST”, minimally invasive small incision, muscle- and rib-sparing thoracotomy, minimally invasive lung cancer radical surgery, was developed to help resolve these problems: helps resect the tumor, minimally invasive, not cost too much, with good prognosis, widely accepted by Chinese patients. We discussed typical cases here.
    
    Methods:
    Case1: Man, aged 80 in Nov 2007, right upper lobe suspected peripheral lung cancer 2.0cm; smoking 57 years, with years’ serious chronic bronchitis, pulmonary bullae, emphysema, and diabetes mellitus, encephalatrophy; chemotherapy and radiation was denied; surgery was denied; VATS was not available then. Case2: Man, aged 68 in Oct 2007, right lower lobe suspected peripheral lung cancer or metastatic cancer 1.5cm; gastric cancer resection in 2002, lung cancer left lower lobe resection in 2006, followed by chemo-radiation; chemotherapy and radiation was denied because of sickly status, age, cardiopulmonary dysfunction, possible resistance to chemotherapy; surgery was denied because of suspected potential multi metastasis, and the heavy risk and difficulties may meet in operation, fear of single one left upper lobe could not ensure the safety of operation and anesthesia, and further resection of the lung will obviously aggravate postoperative pulmonary dysfunction. Both patients were transferred to CMU Lung Cancer Center. “miMRST” wedge resection became the best choice for these aged, cardiopulmonary dysfunction patients with suspected peripheral small lung cancer (≤2cm).
    
    Results:
    About 10cm lateral chest incision was enough for most lung cancer resection and mediastinal lymph node dissection, with the latissimus dorsi and serratus anterior muscles were protected, no rib cut needed. Wedge resection was performed for both patients, and cutting edges of the lung were more than 2-3cm away from the tumors. No swelling lymph node was found and no dissection done. The patients recovered much better and quickly than other patients who underwent traditional “large-incision” posterolateral thoracotomy. Regular follow-up: Case 1 now alive healthily for his 8th year postoperatively, no sign of recurrence and metastasis; Case 2 lived healthily for more than 4 years, no sign of recurrence and metastasis, but died at the 5th year postoperatively due to other reason not lung cancer.
    
    Conclusion:
    miMRST, neither causes serious damage as traditional “large-incision” posterolateral thoracotomy does, nor costs too much as VATS does. miMRST wedge resection is a good choice for aged cardiopulmonary dysfunction patients with peripheral small lung cancer (≤2cm), with a good acceptable prognosis, even cure lung cancer, very suitable for lung cancer surgery in developing countries. (This study was partly supported by the Fund for Scientific Research of The First Hospital of China Medical University, No.FSFH1210).