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V. Bagrov



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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
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      P3.03-019 - Salvage Surgery after Definitive Chemoradiotherapy in NSCLC Patients (ID 304)

      09:30 - 09:30  |  Author(s): V. Bagrov

      • Abstract
      • Slides

      Background:
      The benefits of salvage resection for lung cancer recurrence following high-dose curative-intent chemoradiation therapy are unclear. The study was aimed to assess postoperative morbidity and survival after salvage lung resection following definitive chemoradiation.

      Methods:
      In this retrospective study, medical records of 14 patients undergoing lung cancer resections at our institution following definitive chemoradiation therapy were reviewed from June 2008 to December 2013. There were 10 (71,4%) males and 4 (28,6%) females, median age - 52,6 years. The most common histologic type of lung cancer was squamous cell carcinoma (64,3%). Pretreatment lung cancer stage was IIB - in 2, IIIA - in 11 and IIIB - in one patient. Definitive radiation treatment varied from 45 to 70 Gy (median - 58Gy). Mean number of chemotherapy cycles was 3,8 per patient. Surgery included pneumonectomy in all patients, except one, whom left-lower lobectomy was performed. In all cases bronchial stump was reinforced with a pedicled muscle flap. Postoperative complications were registered according to the Thoracic Morbidity and Mortality System (TMM).

      Results:
      Postoperative complications were registered in 7 (50,0%) patients: grade II complications were detected in 2, grade IIIA – in 1, grade IVA – in 3 and grade V (mortality) – in one patient (7,1%). Pathologic stage was IB – in 2, IIA – in 1, IIB – in 5, IIIA – in 4 and IIIB – in 2 patients. Overall 1, 2 and 3-year survival was 89,1%, 82,0% and 48,0% with median survival 35 months. Disease-free 1, 2 and 3-year survival was 84,2%, 72,0% and 24,8% respectively, median – 28 months. Overall and recurrence-free 5-year survival was 10,8%. Recurrence in the chest was diagnosed in one patient, distant relapse – in 6. No variables were found to be associated with improved post-chemoradiation survival from the time of definitive treatment or postoperative survival.

      Conclusion:
      Salvage lung resection for recurrent lung cancer following definitive chemoradiation therapy is feasible and is associated with postoperative survival and complication rates that are reasonable.

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