Author of

• 16935

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  P1.08 - Poster Session with Presenters Present (ID 460)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16994

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    P1.08-059 - Timing of Surgery after Induction Chemoradiation Therapy for Locally Advanced NSCLC (ID 5695)

    14:30 - 14:30  |  Author(s): S. Sarıhan
    • Abstract

    Background:
    The timing of surgery after induction chemoradiotherapy (ChRT) for locally Advanced NSCLC is accepted crucial because of technical difficulties, morbidity and related mortality. Although six to eight weeks’ time interval between induction ChRT and surgery is advocated, precise analysis of the optimal waiting time that maximizes oncologic benefits of ChRT has not been established. We aimed to review our results of pulmonary resections performed after induction ChRT and to determine the effects of time interval on postoperative morbidity, mortality and long term survival.
    
    Methods:
    We retrospectively reviewed our records for patients undergoing induction ChRT between 1996 and 2015. Timing of treatment was defined as the difference between the last date of radiotherapy and the date of lung resection. The dose of radiotherapy varied from 45Gy to 66Gy. The patients were divided into two groups, surgery less than eight weeks (Group 1) and more than eight weeks (Group 2) following induction ChRT. Type of resection, postoperative complications, 90-days mortality and long-term survival were analyzed. The impact of surgical timing on outcomes was studied through univariable and multivariable analyses.
    
    Results:
    One hundred and forty-two patients were included into study. The mean time interval between ChRT and surgery was 92.3 days (21-900 days). Sixty-five lung resections were performed less than eight and 77 more than eight weeks. Pulmonary resections were classified as pneumonectomy in 20 patients, lobectomy in 122 patients (of whom, 55 underwent extended resections, chest wall, sleeve etc.). Final pathological examination revealed complete response in 43 (30.3%) of the patients. Major morbidity was observed in 42.2% of the patients [43% (28 of 65pts) in group 1 and 41.5% (32 of 77pts) in group 2, p=0.85]. The overall 90-day mortality rate was 6.3% [7.7% in group 1 and 5.2% in group 2, p=0.54]. The mortality rate after pneumonectomy was 5% (1/20) and 6.5% (8/122) after lobectomy. The 5-year survival rate was 61% vs 47% (p = 0.16). Multivariate analysis showed that timing of surgery after ChRT was not significantly associated with an increased morbidity and mortality that was also not effected by the dose of radiotherapy.
    
    Conclusion:
    These findings indicate that lobectomy or pneumonectomy can be safely performed eight weeks or more after induction ChRT without affecting surgical morbidity and mortality. Pulmonary resection may be performed safely even one year after ChRT.