Results of superior vena cava resection for lung cancer - Analysis of prognostic factors

被引:60
作者
Spaggiari, L
Magdeleinat, P
Kondo, H
Thomas, P
Leon, ME
Rollet, G
Regnard, JF
Tsuchiya, R
Pastorino, U
机构
[1] European Inst Oncol, Dept Thorac Surg, I-20141 Milan, Italy
[2] Hop Hotel Dieu, Dept Thorac Surg, F-75181 Paris, France
[3] Natl Canc Ctr, Dept Thorac Surg, Tokyo 104, Japan
[4] St Marguerite Univ Hosp, Dept Thorac Surg, Marseille, France
[5] European Inst Oncol, Dept Biostat, Milan, Italy
关键词
lung cancer; superior vena cava; surgery; extended resection; T4; mediastinal surgery; vascular surgery;
D O I
10.1016/j.lungcan.2003.11.010
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aims: The benefits of superior vena cava (SVC) resection for lung cancer remain controversial. Data obtained in four international centers were analyzed in order to identify prognostic factors and thus guide in future patient selection. Materials and methods: Retrospective study. Prognostic factors were examined by logistic regression for postoperative morbidity/mortality using the Kaplan-Meier method (log rank test) and the Cox proportional-hazard model for survival. Results: From 1963 to 2000, 109 patients underwent SVC resection. Induction treatment was given to 23 (21%) patients. The SVC was resected for T involvement in 78 (72%) cases and for N involvement in 31 (28%) cases. Fifty-five (50.5%) patients underwent pneumonectomy (20 with carinal resection), while the remaining underwent lobar resections. Prosthetic SVC replacement was performed in 28 (26%) patients; partial resection with running suture (53%), vascular stapler (13%), or patch (7%) was performed in 80 patients; 1 patient did not undergo reconstruction. Pathological examination identified direct involvement (T4) in 66 (60%) patients and N2 disease in 55 (50%) patients. Major postoperative morbidity and mortality were 30 and 12%, respectively. Median intensive care unit stay was 3 days, while median hospital stay was 16 days. Five-year survival was at 21%, with median survival at 11 months. In multiple regression analysis, induction treatment was associated with an increased risk of major complications (P = 0.016). None of the factors assessed demonstrated an association with postoperative death. In multivariate survival analysis, both pneumonectomy and complete resection of the SVC with prosthetic replacement were associated with a significant increased risk of death (P = 0.0013 and 0.014, respectively). Conclusions: The radical resection of lung cancer involving the SVC may result in a permanent cure in carefully selected patients. The type of pulmonary resection (i.e., pneumonectomy) and the type of SVC resection (i.e., complete resection with prosthetic replacement) are the prognostic factors with the greatest adverse effect on survival. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:339 / 346
页数:8
相关论文
共 50 条
  • [31] Surgical reconstruction of the superior vena cava system: Indications and results
    Picquet, Jean
    Blin, Vincent
    Dussaussoy, Corinne
    Jousset, Yann
    Papon, Xavier
    Enon, Bernard
    [J]. SURGERY, 2009, 145 (01) : 93 - 99
  • [32] Superior vena cava resection in thoracic malignancies: does prosthetic replacement pose a higher risk?
    Leo, Francesco
    Bellini, Roberto
    Conti, Barbara
    Delledonne, Vincenzo
    Tavecchio, Luca
    Pastorino, Ugo
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2010, 37 (04) : 764 - 769
  • [33] Usefulness of a temporary shunt by cannulation during superior vena cava combined resection
    Funai, Kazuhito
    Kawase, Akikazu
    Takanashi, Yusuke
    Mizuno, Kiyomichi
    Shiiya, Norihiko
    [J]. GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2022, 70 (07) : 680 - 682
  • [34] Superior Vena Cava Resection in Locally Advanced Thymoma—Surgical and Survival Outcomes
    Arvind Kumar
    Mohan Venkatesh Pulle
    Belal Bin Asaf
    Ganesh Shivnani
    Arun Maheshwari
    Srinivas Gopinath Kodaganur
    Harsh Vardhan Puri
    Sukhram Bishnoi
    [J]. Indian Journal of Surgical Oncology, 2020, 11 : 711 - 719
  • [35] SUPERIOR VENA-CAVA OBSTRUCTION IN A PATIENT WITH CHRONIC LYMPHOCYTIC-LEUKEMIA AND LUNG-CANCER
    DEMAYOLO, JA
    SRIDHAR, KS
    KUNHARDT, B
    RAO, RK
    [J]. AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1992, 15 (04): : 352 - 355
  • [36] Prognostic factors following complete resection of non-superior sulcus lung cancer invading the chest wall
    Jones, Gregory D.
    Caso, Raul
    No, Jae Seong
    Tan, Kay See
    Dycoco, Joseph
    Bains, Manjit S.
    Rusch, Valerie W.
    Huang, James
    Isbell, James M.
    Molena, Daniela
    Park, Bernard J.
    Jones, David R.
    Rocco, Gaetano
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2020, 58 (01) : 78 - 85
  • [37] Leiomyosarcoma of the superior vena cava: Resection with vascular reconstruction - case report and review of the literature
    Katz, Michael G.
    Dekel, Hagi
    Elias, Sorin
    Kravtsov, Vladimir
    Didkovsky, Elena
    Sasson, Lior
    [J]. INTERNATIONAL JOURNAL OF ANGIOLOGY, 2007, 16 (04) : 152 - 154
  • [38] Patency of grafts after total resection and reconstruction of the superior vena cava for thoracic malignancy
    Oizumi, Hiroaki
    Suzuki, Kenji
    Banno, Takamitsu
    Matsunaga, Takeshi
    Oh, Shiaki
    Takamochi, Kazuya
    [J]. SURGERY TODAY, 2016, 46 (12) : 1421 - 1426
  • [39] Patency of grafts after total resection and reconstruction of the superior vena cava for thoracic malignancy
    Hiroaki Oizumi
    Kenji Suzuki
    Takamitsu Banno
    Takeshi Matsunaga
    Shiaki Oh
    Kazuya Takamochi
    [J]. Surgery Today, 2016, 46 : 1421 - 1426
  • [40] LUNG HYDATID CYST CAUSING VENA CAVA SUPERIOR SYNDROME: A CASE REPORT
    Aydogdu, Koray
    Aydin, Ertan
    Gulgosteren, Mahmut
    Findik, Gokturk
    Karaoglanoglu, Nurettin
    [J]. TURKISH JOURNAL OF GERIATRICS-TURK GERIATRI DERGISI, 2011, 14 (02): : 160 - 163