Ryuichi Waseda1,2, Thomas Klikovits1, Mir Alireza Hoda1, Konrad Hoetzenecker1, Pietro Bertoglio1, Karin Dieckmann3, Sabine Zöchbauer-Müller4, Robert Pirker4, Helmut Prosch5, Balazs Döme1,6,7, Walter Klepetko1. 1. Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria. 2. Department of General Thoracic, Breast and Pediatric Surgery, School of Medicine, Fukuoka University, Fukuoka, Japan. 3. Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria. 4. Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Austria. 5. Department of Radiology, Comprehensive Cancer Center, Medical University of Vienna, Austria. 6. National Korányi Institute of Pulmonology, Budapest, Hungary. 7. Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Austria.
Abstract
OBJECTIVE: This study aims to evaluate the impact of T stage and extended surgery on the outcome of patients with Pancoast tumors after induction chemoradiation therapy. METHODS: Forty-six consecutive patients who underwent chemoradiation therapy (platin-based, 45-66 Gy) followed by surgery between 1998 and 2013 were retrospectively reviewed and analyzed. RESULTS: In 28 (61%) patients with T4 tumors, extended procedures (more than rib resection) were performed. There were 37 (80%) lobectomies, 6 (13%) pneumonectomies, and 3 (7%) sublobar resections. A total of 44 (96%) patients had R0 resection. About 30-day mortality was 0%, major surgical complications occurred in 9 (19.6%) patients. Overall survival (OS) at 5-years was 63%. Disease-free survival (DFS) at 5-years was 45%. At multivariate cox regression analysis adjusted for clinical factors, T factor (T3/T4) and extended surgical procedures did not impact survival. However, pathological positive N stage had a negative impact on OS and lack of pathological response negatively impacted both OS and DFS. CONCLUSION: Trimodality treatment including radical resection for Pancoast tumors provides good surgical outcome and favorable long-term results. Survival of patients with T4 tumors and extended surgical procedures comparable to that of patients with T3 tumors undergoing rib resection only.
OBJECTIVE: This study aims to evaluate the impact of T stage and extended surgery on the outcome of patients with Pancoast tumors after induction chemoradiation therapy. METHODS: Forty-six consecutive patients who underwent chemoradiation therapy (platin-based, 45-66 Gy) followed by surgery between 1998 and 2013 were retrospectively reviewed and analyzed. RESULTS: In 28 (61%) patients with T4 tumors, extended procedures (more than rib resection) were performed. There were 37 (80%) lobectomies, 6 (13%) pneumonectomies, and 3 (7%) sublobar resections. A total of 44 (96%) patients had R0 resection. About 30-day mortality was 0%, major surgical complications occurred in 9 (19.6%) patients. Overall survival (OS) at 5-years was 63%. Disease-free survival (DFS) at 5-years was 45%. At multivariate cox regression analysis adjusted for clinical factors, T factor (T3/T4) and extended surgical procedures did not impact survival. However, pathological positive N stage had a negative impact on OS and lack of pathological response negatively impacted both OS and DFS. CONCLUSION: Trimodality treatment including radical resection for Pancoast tumors provides good surgical outcome and favorable long-term results. Survival of patients with T4 tumors and extended surgical procedures comparable to that of patients with T3 tumors undergoing rib resection only.
Authors: Alessandra Buja; Giulia Pasello; Marco Schiavon; Giuseppe De Luca; Michele Rivera; Claudia Cozzolino; Anna De Polo; Manuela Scioni; Alberto Bortolami; Vincenzo Baldo; PierFranco Conte Journal: Thorac Cancer Date: 2022-08-15 Impact factor: 3.223
Authors: Alessandra Buja; Michele Rivera; Anna De Polo; Eugenio di Brino; Marco Marchetti; Manuela Scioni; Giulia Pasello; Alberto Bortolami; Vincenzo Rebba; Marco Schiavon; Fiorella Calabrese; Giovanni Mandoliti; Vincenzo Baldo; PierFranco Conte Journal: Thorac Cancer Date: 2020-11-21 Impact factor: 3.500