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Y. Yagi



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    OA 04 - Surgery from Minimal to Radical (ID 661)

    • Event: WCLC 2017
    • Type: Oral
    • Track: Surgery
    • Presentations: 1
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      OA 04.02 - Feasibility of Pulmonary Resection Following Definitive Chemoradiotherapy for Primary Lung Carcinoma (ID 9633)

      15:55 - 16:05  |  Author(s): Y. Yagi

      • Abstract
      • Presentation
      • Slides

      Background:
      Induction chemoradiation (ICR) for advanced non-small cell lung caner is often limited to 50Gy or less to avoid perioperative complications. Pulmonary resection following definitive chemoradiotherapy (DCR) has been an alternative approach for locally advanced lung cancer.

      Method:
      In this study, we compared pulmonary resection following ICR and DCR. From 1997 to 2016, we had 31 pulmonary resections following CR. There were 13 ICR and 18 DCR. Intercostal muscle flaps were used in 7 ICR and 2 DCR. Omental flaps were used in 12 DCR. Pericardial fat pad was used in 1 DCR．There was no mortality in any groups.

      Result:
      In comparison with ICR and HCR, operation time (min, interquartile range) were 344 (283-513) and 418 (563-572) (p = 0.057), estimated blood loss (ml) were 440 (225-575) and 525 (323-1313) (p =0,262), morbidity (%), 69 and 28 (p = 0.021). Bronchopleural fistula developed in one case of DCR who used intercostal muscle flap. Post operation hospital stay (days) was 21 (13.5-26.5) in ICR, 14.5 (13-20) in DCR (P = 0.221). Although operation time was longer and there were more blood loss in DCR, there was no significant increase of peri- and post-operative complications. 2- and 5-year over all survival rates (%) were 50 and 42 in ICR, and 68 and 51 in DCR (p=0.73, log-rank test).

      Conclusion:
      As a conclusion, high dose ICR may contribute to better local control and longer survival. Pulmonary resection after DCR is as safe as that following ICR.

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