The Feasibility of Median Sternotomy With or Without Thoracotomy for Locally Advanced Non-Small Cell Lung Cancer Treated With Induction Chemoradiotherapy

被引:6
|
作者
Sato, Hiroki
Toyooka, Shinichi
Soh, Junichi
Hotta, Katsuyuki
Katsui, Kuniaki
Yamamoto, Hiromasa
Sugimoto, Seiichiro
Oto, Takahiro
Kanazawa, Susumu
Kiura, Katsuyuki
Miyoshi, Shinichiro
机构
[1] Okayama Univ Hosp, Dept Thorac Surg, Okayama, Japan
[2] Okayama Univ Hosp, Dept Clin Genom Med, Okayama, Japan
[3] Okayama Univ Hosp, Dept Resp Med, Okayama, Japan
[4] Okayama Univ Hosp, Dept Radiol, Okayama, Japan
来源
ANNALS OF THORACIC SURGERY | 2016年 / 102卷 / 03期
关键词
PULMONARY RESECTION; CONCURRENT CHEMORADIOTHERAPY; SURGICAL RESECTION; CARINAL RESECTION; PHASE-III; CHEMOTHERAPY; CISPLATIN; RADIATION; DOCETAXEL; SURGERY;
D O I
10.1016/j.athoracsur.2016.03.092
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. This study aimed to compare the morbidity and mortality of a median sternotomy approach and a lateral thoracotomy and to investigate the feasibility of a median sternotomy for locally advanced non-small cell lung cancer (NSCLC) after induction chemoradiotherapy. Methods. The medical records of patients with locally advanced NSCLC who underwent induction chemoradiotherapy followed by surgery at our institution between January 1999 and September 2014 were reviewed. We compared the morbidity and mortality of a median sternotomy approach and a lateral thoracotomy. Results. A total of 102 NSCLC patients were the subjects of this study. Among them, 31 patients underwent surgery with a median sternotomy approach and 71 patients underwent surgery with a lateral thoracotomy. Patients in the median sternotomy group had a significantly higher rate of postoperative arrhythmia than those in the lateral thoracotomy group (p = 0.0028). However, all the complications were manageable, and no treatment-related deaths occurred in the median sternotomy group. Regarding the prognosis, the 5-year overall survival rate was 72.7%, and the 2-year recurrence-free survival rate was 66.5% in the entire population. No significant differences in overall survival or recurrence-free survival were observed between the 2 approaches. Conclusions. Whereas the lateral thoracotomy approach is a standard procedure, our experience suggests that a median sternotomy approach for locally advanced NSCLC after induction chemoradiotherapy is a feasible procedure and can be a surgical option. (C) 2016 by The Society of Thoracic Surgeons
引用
收藏
页码:985 / 992
页数:8
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