Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

被引:4
作者
Fourdrain, Alex [1 ]
Bagan, Patrick [1 ,2 ]
Georges, Olivier [1 ]
Lafitte, Sophie [1 ]
De Dominicis, Florence [1 ]
Meynier, Jonathan [3 ]
Berna, Pascal [1 ]
机构
[1] Amiens Univ Hosp, Dept Thorac Surg, F-80054 Amiens, France
[2] Victor Dupouy Hosp, Dept Thorac & Vasc Surg, Argenteuil, France
[3] Amiens Univ Hosp, Dept Biostat, Clin Res & Innovat Directorate, Amiens, France
关键词
lung cancer; lobectomy; multiple primary; mortality; survival; SURVIVAL; MANAGEMENT; 2ND;
D O I
10.1055/s-0040-1710068
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Patients treated surgically for lung cancer may present synchronous or metachronous lung cancers. The aim of this study was to evaluate outcomes after a second contralateral anatomic surgical resection for lung cancer. Methods We performed a retrospective two-center study, based on a prospective indexed database. Included patients were treated surgically by bilateral anatomic surgical resection for a second primary lung cancer. We excluded nonanatomic resections, benign lesions, and ipsilateral second surgical resections. Results Between January 2011 and September 2018, 55 patients underwent contralateral anatomic surgical resections for lung cancer, mostly for metachronous cancers. The first surgical resection was a lobectomy in most cases (45 lobectomies: 81.8%, 9 segmentectomies: 16.4%, and 1 bilobectomy: 1.8%), and a video-assisted thoracic surgery (VATS) procedure was used in 23 cases (41.8%). The mean interval between the operations was 38 months, and lobectomy was less frequent for the second surgical resection (35 lobectomies: 63.6% and 20 segmentectomies: 36.4%), with VATS procedures performed in 41 cases (74.5%). Ninety-day mortality was 10.9% ( n =6), and 3-year survival was 77%. Risk factor analysis identified the number of resected segments during the second intervention or the total number of resected segments, extent of resection (lobectomy vs. segmentectomy), surgical approach (thoracotomy vs. VATS), tumor stage, and nodal involvement as potential prognostic factors for long-term survival. Conclusion A second contralateral anatomic surgical resection for multiple primary lung cancer is possible, with a higher early mortality rate, but acceptable long-term survival, and should be indicated for carefully selected patients.
引用
收藏
页码:373 / 379
页数:7
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