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)

  • 17004

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    P1.08-069 - One Surgeon's 30-Year Experience of Surgical Treatment for Pancoast Tumor (ID 5406)

    14:30 - 14:30  |  Author(s): Y. Kaminuma
    • Abstract

    Background:
    Surgical treatment for Pancoast tumor has made marked progress, and the patient outcome has improved significantly over the last three decades. Developments of some new surgical approaches and the application of preoperative chemo-radiotherapy markedly contributed.
    
    Methods:
    We retrospectively analyzed the patients who received surgical treatment in two institutes between 1984 and 2013. One surgeon planned the surgical treatment and performed the operation in all patients.
    
    Results:
    Seventy-two patients received surgical treatment. There were 61 males and 11 females, with median age of 61 years old (33-83 years). There were 26 adenocarcinomas, 26 squamous cell carcinomas, 10 large cell carcinomas, and 10 other pathologies. Forty patients received preoperative induction therapy. Twenty-five patients were treated by induction chemo-radiotherapy with a platinum doublet and 40-50 Gy of concurrent radiotherapy. Fourteen patients received radiotherapy alone, and another one patient received chemotherapy alone. The surgical approach was selected based on the tumor location. An anterior approach including Masaoka’s approach, Dartevele’s approach, and Grunennwald’s approach were adopted for 19 patients. Posterior approach, all involving a hook approach was employed in 52 patients. One patient was operated on using both anterior and posterior approaches. Combined resection excluding the chest wall was performed in 59 patients. The brachial plexus (Th1) in 48 patients, thoracic vertebrae in 17, subclavian artery in eleven, and subclavian vein in 5 were removed with the tumor. In 52 patients (72.2%), the tumors were completely removed. The morbidity rate was 37.5% and mortality rate was 2.8%. One patient died of bleeding from rapture of an aortic anastomosis, and another patient died of esophago-pleural fistula. The 5-year survival rate for all patients was 44%, with a median survival time of 19.5 months. The 5-year survival rate based on the operation date was 31.7% for the first half (1984-1999) and 59.1% for the second half (2000-2013) (p=0.035). The 5-year survival rates of patients who received and did not receive induction chemo-radiotherapy were 63.0 and 34.8%, respectively.
    
    Conclusion:
    The survival rate after surgical therapy for Pancoast tumor significantly improved over the three decades. Preoperative chemo-radiotherapy and the selection of an approach based on the tumor location contributed to the improvement.