H S Hofmann1, C Taege, C Lautenschläger, H Neef, R E Silber. 1. Department of Cardio-Thoracic Surgery, Martin Luther University, E.-Grube Strasse 40, 06097 Halle, Germany. stefan.hofmann@medizin.uni-halle.de
Abstract
OBJECTIVES: This retrospective study evaluates the probability of survival in patients who had undergone resection for non-small cell lung cancer (NSCLC) and in whom residual disease at the resection margins was found. METHODS: During a period of 6 years, 596 patients with NSCLC were operated upon with curative intention. Residual disease at the resection margin was divided into microscopic (R1) and macroscopic (R2). RESULTS: Twenty-six patients (4.4%) showed R1 and 12 (2%) R2 residual disease. An extrabronchial (thoracic wall, vessels) R1 situation was found in five patients and a bronchial R1 infiltration in 21 cases. The bronchial resection margin was subject to peribronchial infiltration in most cases (16/21). A total of 17/21 (65%) patients with bronchial infiltration had N2 disease. Thirty day lethality was 3.8% in the R1 group. Fifteen patients had postoperative irradiation. The 5-year survival rate for patients with R1 resection was 14%. The differences in survival between patients with extrabronchial vs. bronchial infiltration and N0/N1 vs. N2 were significant using univariate analysis. Adjuvant radiation did not result (especially in N2 disease) in a survival benefit. Among 12 patients with macroscopic residual disease (R2), 3/12 (25%) died within the first 30 days after the operation, and none of the R2 patients survived the first year after the operation. CONCLUSIONS: Patients with an R1 situation have a survival rate of 14% comparable to curative resected patients (RO) in stage III. Adjuvant radiation had no clear effect on survival. Patients with macroscopic tumor (R2) should receive palliative treatment after the operation depending on their condition.
OBJECTIVES: This retrospective study evaluates the probability of survival in patients who had undergone resection for non-small cell lung cancer (NSCLC) and in whom residual disease at the resection margins was found. METHODS: During a period of 6 years, 596 patients with NSCLC were operated upon with curative intention. Residual disease at the resection margin was divided into microscopic (R1) and macroscopic (R2). RESULTS: Twenty-six patients (4.4%) showed R1 and 12 (2%) R2 residual disease. An extrabronchial (thoracic wall, vessels) R1 situation was found in five patients and a bronchial R1 infiltration in 21 cases. The bronchial resection margin was subject to peribronchial infiltration in most cases (16/21). A total of 17/21 (65%) patients with bronchial infiltration had N2 disease. Thirty day lethality was 3.8% in the R1 group. Fifteen patients had postoperative irradiation. The 5-year survival rate for patients with R1 resection was 14%. The differences in survival between patients with extrabronchial vs. bronchial infiltration and N0/N1 vs. N2 were significant using univariate analysis. Adjuvant radiation did not result (especially in N2 disease) in a survival benefit. Among 12 patients with macroscopic residual disease (R2), 3/12 (25%) died within the first 30 days after the operation, and none of the R2 patients survived the first year after the operation. CONCLUSIONS:Patients with an R1 situation have a survival rate of 14% comparable to curative resected patients (RO) in stage III. Adjuvant radiation had no clear effect on survival. Patients with macroscopic tumor (R2) should receive palliative treatment after the operation depending on their condition.
Authors: Vignesh Raman; Oliver K Jawitz; Chi-Fu J Yang; Soraya L Voigt; Anthony W Kim; Betty C Tong; Thomas A D'Amico; David H Harpole Journal: J Thorac Cardiovasc Surg Date: 2019-09-30 Impact factor: 5.209
Authors: Otto C Burghuber; Klaus Kirchbacher; Andrea Mohn-Staudner; Maximilian Hochmair; Marie-Kathrin Breyer; Michael Studnicka; Michael Rolf Mueller; Petra Feurstein; Andrea Schrott; Bernd Lamprecht; Josef Eckmayr; Friedrich Renner; Josef Bolitschek; Wolfgang Pohl; Peter Schenk; Peter Errhalt; Peter Cerkl; Bernhard Baumgartner; Meinhard Kneussl; Sylvia Hartl Journal: Clin Med Insights Oncol Date: 2020-09-10
Authors: Lisanne K A Neijenhuis; Lysanne D A N de Myunck; Okker D Bijlstra; Peter J K Kuppen; Denise E Hilling; Frank J Borm; Danielle Cohen; J Sven D Mieog; Willem H Steup; Jerry Braun; Jacobus Burggraaf; Alexander L Vahrmeijer; Merlijn Hutteman Journal: Life (Basel) Date: 2022-03-17