Author of

• 20195

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  P3.16 - Surgery (ID 732)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24260

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    P3.16-037 - Superior Vena Cava Replacement Combined with Veno-Venous Shunt for Lung Cancer and Thymoma: Case Series (ID 8036)

    09:30 - 09:30  |  Author(s): T.P. Xie
    • Abstract
    • Slides

    Background:
    Superior vena cava (SVC) replacement is infrequently performed and technically challenging in low-volume centers. Veno-venous shunt (VVS) technique is used to reduce SVC pressure during SVC replacement and has not been well reported. This study aims to add experience on this subject and evaluate the surgical outcomes of patients who undergo SVC replacement combined with VVS in our center.
    
    Method:
    A retrospective analysis of six patients who received SVC replacement combined with VVS from September 2011 to February 2017 was performed. Clinical characteristics, pathological features, operative characteristics, postoperative outcomes and survival of six patients were reviewed.
    
    Result:
    There were four males and two females with a median age of 44 years (range, 35-69 years). There were three lung cancer patients and three thymoma patients at a stage from IIIA to IVA. Five patients underwent induction therapy. Complete resection was performed on five patients. One case underwent internal VVS, and the other five cases underwent external VVS. Prosthesis grafts were employed in five cases and autologous pericardium in one case. Three cases underwent single-vein reconstruction, and the other three cases underwent double-vein reconstruction. The median SVC clamping time was 75 minutes. There were no postoperative deaths and major complications. All follow-up patients were alive, and no thrombosis was found in all the grafts.

    Table 1 Clinical and pathological characteristics of six patients

    Case	Year	Age(years),sex	Tumor	Status	Treatment	Response after induction	Histology	Stage
    1	2011	35,male	Thymoma	Primary	CRT+S+CT+S	PR	B2 thymoma	IVA
    2	2012	46,male	Lung cancer	Primary	CT+S+CT	PR	Adenocarcinoma	pT4N2M0, IIIB
    3	2015	37,female	Thymoma	Primary	CRT+S+CT	PR	B2 thymoma	III
    4	2015	42,female	Thymoma	Recurrence	S+RCT	-	B1 thymoma	III
    5	2016	54,male	Lung cancer	Primary	CT+S+CRT	SD	Squamous cell carcinoma	pT4N2M0, IIIB
    6	2017	69,male	Lung cancer	Recurrence	CRT+S+CT	SD	Squamous cell carcinoma	pT4N0M0, IIIA

    CRT, chemoradiotherapy; CT, chemotherapy; PR, partial response; RT, radiotherapy; S, surgery; SD, stable disease
    
    Conclusion:
    SVC replacement combined with VVS is technically feasible and safe. Although VVS technique is not a must, it may make SVC replacement safer in inexperienced centers. Surgery-based multidisciplinary treatment for selected patients with type T4 lung cancer and SVC involvement or thymoma and SVC involvement may achieve a favorable long-term outcome.
    
    

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