C Dickhoff1, M Dahele2, M A Paul3, P M van de Ven4, A J de Langen5, S Senan2, E F Smit6, K J Hartemink7. 1. Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: chrisdickhoff@yahoo.com. 2. Department of Radiation Oncology VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. 3. Department of Cardiothoracic Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. 4. Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. 5. Department of Pulmonary Diseases, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. 6. Department of Pulmonary Diseases, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands. 7. Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.
Abstract
OBJECTIVES: Curative intent treatment options for locoregional recurrence or persistent tumor after radical chemoradiotherapy for locally-advanced non-small cell lung cancer (NSCLC) are limited. In selected patients, surgery can be technically feasible, although it is widely believed to be hazardous. As data regarding the outcome of this approach is sparse, we evaluated our institutional experience with salvage surgery. MATERIALS AND METHODS: Patients with a pulmonary resection for in-field locoregional recurrence or persistent tumor after high dose chemoradiotherapy (≥60 Gy) for the treatment of non-small cell lung cancer, were identified and retrospectively analyzed. RESULTS: A total of 15 patients treated between January 2007 and August 2015 were eligible for evaluation. In 13 patients (87%), the indication for surgery was a locoregional recurrence, while 2 patients had persistent tumor. The prior median radiotherapy dose was 66 Gy (range 60-70). All patients underwent an anatomical resection, with 8 patients having a pneumonectomy, and all pathological specimens revealed the presence of viable tumor. The in-hospital morbidity rate was 40% (6 patients), and the 90-day mortality rate was 6.7% (1 patient). Median follow-up was 12.1 months. The estimated median overall and event-free survivals were 46 months and 43.6 months, respectively. CONCLUSION: Salvage surgery for locoregional recurrence or persistent tumor after high dose chemoradiotherapy, resulted in acceptable morbidity, mortality and promising outcome. It should be considered as a treatment option for selected patients.
OBJECTIVES: Curative intent treatment options for locoregional recurrence or persistent tumor after radical chemoradiotherapy for locally-advanced non-small cell lung cancer (NSCLC) are limited. In selected patients, surgery can be technically feasible, although it is widely believed to be hazardous. As data regarding the outcome of this approach is sparse, we evaluated our institutional experience with salvage surgery. MATERIALS AND METHODS:Patients with a pulmonary resection for in-field locoregional recurrence or persistent tumor after high dose chemoradiotherapy (≥60 Gy) for the treatment of non-small cell lung cancer, were identified and retrospectively analyzed. RESULTS: A total of 15 patients treated between January 2007 and August 2015 were eligible for evaluation. In 13 patients (87%), the indication for surgery was a locoregional recurrence, while 2 patients had persistent tumor. The prior median radiotherapy dose was 66 Gy (range 60-70). All patients underwent an anatomical resection, with 8 patients having a pneumonectomy, and all pathological specimens revealed the presence of viable tumor. The in-hospital morbidity rate was 40% (6 patients), and the 90-day mortality rate was 6.7% (1 patient). Median follow-up was 12.1 months. The estimated median overall and event-free survivals were 46 months and 43.6 months, respectively. CONCLUSION: Salvage surgery for locoregional recurrence or persistent tumor after high dose chemoradiotherapy, resulted in acceptable morbidity, mortality and promising outcome. It should be considered as a treatment option for selected patients.
Authors: Angel Cilleruelo-Ramos; Esther Cladellas-Gutiérrez; Carolina de la Pinta; Laura Quintana-Cortés; Paloma Sosa-Fajardo; Felipe Couñago; Xabier Mielgo-Rubio; Juan Carlos Trujillo-Reyes Journal: World J Clin Oncol Date: 2021-12-24
Authors: Pieter J M Joosten; Toon A Winkelman; David J Heineman; Sayed M S Hashemi; Idris Bahce; Suresh Senan; Marinus A Paul; Koen J Hartemink; Max Dahele; Chris Dickhoff Journal: JTO Clin Res Rep Date: 2021-04-15
Authors: Chris Dickhoff; Suresh Senan; Famke L Schneiders; Joris Veltman; Sayed Hashemi; Johannes M A Daniels; Marieke Fransen; David J Heineman; Teodora Radonic; Peter M van de Ven; Imke H Bartelink; Lilian J Meijboom; Juan J Garcia-Vallejo; Daniela E Oprea-Lager; Tanja D de Gruijl; Idris Bahce Journal: BMC Cancer Date: 2020-08-14 Impact factor: 4.430