Extended resections for bronchogenic carcinoma invading the superior vena cava system
Background. Extended resection of non-small-cell lung cancer (NSCLC) involving the superior vena cava (SVC) system is infrequently performed and oncologic benefits are still uncertain. Methods. From 1983 to 1996, 25 patients underwent resection of the SVC system for T4, NSCLC. Results. A total of 12...
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| Veröffentlicht in: | The Annals of thoracic surgery 2000-01, Vol.69 (1), p.233-236 |
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| creator | Spaggiari, Lorenzo Regnard, Jean-François Magdeleinat, Pierre Jauffret, Bertrand Puyo, Philippe Levasseur, Philippe |
| description | Background. Extended resection of non-small-cell lung cancer (NSCLC) involving the superior vena cava (SVC) system is infrequently performed and oncologic benefits are still uncertain.
Methods. From 1983 to 1996, 25 patients underwent resection of the SVC system for T4, NSCLC.
Results. A total of 12 pneumonectomies (48%), ten lobectomies (40%), and three wedge resections (12%) were performed. Seven patients had complete resection of the SVC with graft interposition, 12 patients underwent tangential resection of the SVC, and 1 patient had a pericardial patch; 5 patients underwent resection of right innominate and subclavian veins without vessel reconstruction. The lymph node status was N0 in 8 patients (32%), N1 in 3 (12%) and N2 in 14 patients (56%). Five patients (20%) underwent incomplete resection. Nine patients (36%) developed postoperative complications (36%) that were fatal in 3 patients (12%). At the completion of the study, 10 patients were still alive. The median survival was 11.5 months and the 5-year actuarial survival rate was 29%, with 4 patients alive at 5 years.
Conclusions. The resection of the SVC system for direct involvement by T4, NSCLC can be performed in selected patients with an acceptable postoperative mortality. Even though no significant prognostic factors were observed, the patients who required a lobectomy with limited lymph node involvement seemed to benefit the most from surgery. |
| doi_str_mv | 10.1016/S0003-4975(99)00867-X |
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Methods. From 1983 to 1996, 25 patients underwent resection of the SVC system for T4, NSCLC.
Results. A total of 12 pneumonectomies (48%), ten lobectomies (40%), and three wedge resections (12%) were performed. Seven patients had complete resection of the SVC with graft interposition, 12 patients underwent tangential resection of the SVC, and 1 patient had a pericardial patch; 5 patients underwent resection of right innominate and subclavian veins without vessel reconstruction. The lymph node status was N0 in 8 patients (32%), N1 in 3 (12%) and N2 in 14 patients (56%). Five patients (20%) underwent incomplete resection. Nine patients (36%) developed postoperative complications (36%) that were fatal in 3 patients (12%). At the completion of the study, 10 patients were still alive. The median survival was 11.5 months and the 5-year actuarial survival rate was 29%, with 4 patients alive at 5 years.
Conclusions. The resection of the SVC system for direct involvement by T4, NSCLC can be performed in selected patients with an acceptable postoperative mortality. Even though no significant prognostic factors were observed, the patients who required a lobectomy with limited lymph node involvement seemed to benefit the most from surgery.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(99)00867-X</identifier><identifier>PMID: 10654520</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Actuarial Analysis ; Adult ; Aged ; Biological and medical sciences ; Blood Vessel Prosthesis Implantation ; Brachiocephalic Veins - surgery ; Carcinoma, Bronchogenic - secondary ; Carcinoma, Bronchogenic - surgery ; Carcinoma, Non-Small-Cell Lung - surgery ; Cause of Death ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms - surgery ; Lymphatic Metastasis ; Male ; Medical sciences ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pericardium - transplantation ; Pneumonectomy - methods ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Subclavian Vein - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the respiratory system ; Survival Rate ; Vascular Neoplasms - surgery ; Vena Cava, Superior - surgery</subject><ispartof>The Annals of thoracic surgery, 2000-01, Vol.69 (1), p.233-236</ispartof><rights>2000 The Society of Thoracic Surgeons</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-aa2bc623e3696eb5574a3299f3978ef8cc9ec180f8e45b56efbe85dfabbaf2513</citedby><cites>FETCH-LOGICAL-c472t-aa2bc623e3696eb5574a3299f3978ef8cc9ec180f8e45b56efbe85dfabbaf2513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(99)00867-X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1246353$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10654520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spaggiari, Lorenzo</creatorcontrib><creatorcontrib>Regnard, Jean-François</creatorcontrib><creatorcontrib>Magdeleinat, Pierre</creatorcontrib><creatorcontrib>Jauffret, Bertrand</creatorcontrib><creatorcontrib>Puyo, Philippe</creatorcontrib><creatorcontrib>Levasseur, Philippe</creatorcontrib><title>Extended resections for bronchogenic carcinoma invading the superior vena cava system</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Extended resection of non-small-cell lung cancer (NSCLC) involving the superior vena cava (SVC) system is infrequently performed and oncologic benefits are still uncertain.
Methods. From 1983 to 1996, 25 patients underwent resection of the SVC system for T4, NSCLC.
Results. A total of 12 pneumonectomies (48%), ten lobectomies (40%), and three wedge resections (12%) were performed. Seven patients had complete resection of the SVC with graft interposition, 12 patients underwent tangential resection of the SVC, and 1 patient had a pericardial patch; 5 patients underwent resection of right innominate and subclavian veins without vessel reconstruction. The lymph node status was N0 in 8 patients (32%), N1 in 3 (12%) and N2 in 14 patients (56%). Five patients (20%) underwent incomplete resection. Nine patients (36%) developed postoperative complications (36%) that were fatal in 3 patients (12%). At the completion of the study, 10 patients were still alive. The median survival was 11.5 months and the 5-year actuarial survival rate was 29%, with 4 patients alive at 5 years.
Conclusions. The resection of the SVC system for direct involvement by T4, NSCLC can be performed in selected patients with an acceptable postoperative mortality. Even though no significant prognostic factors were observed, the patients who required a lobectomy with limited lymph node involvement seemed to benefit the most from surgery.</description><subject>Actuarial Analysis</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Brachiocephalic Veins - surgery</subject><subject>Carcinoma, Bronchogenic - secondary</subject><subject>Carcinoma, Bronchogenic - surgery</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Pericardium - transplantation</subject><subject>Pneumonectomy - methods</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Subclavian Vein - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the respiratory system</subject><subject>Survival Rate</subject><subject>Vascular Neoplasms - surgery</subject><subject>Vena Cava, Superior - surgery</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0E1PwyAYwHFiNDqnH0HTgzF6qFJaKJyMWeZLYuJBl3gjlD5MzAoTukW_vbgt6s0TIfweIH-Ejgp8UeCCXT5hjMu8EjU9E-IcY87q_GULDQpKSc4IFdto8EP20H6Mb2lL0vEu2iswoxUleIAm448eXAttFiCC7q13MTM-ZE3wTr_6KTirM62Cts53KrNuqVrrpln_CllczCHYhJfgVEJLlcXP2EN3gHaMmkU43KxDNLkZP4_u8ofH2_vR9UOuq5r0uVKk0YyUUDLBoKG0rlRJhDClqDkYrrUAXXBsOFS0oQxMA5y2RjWNMoQW5RCdru-dB_--gNjLzkYNs5ly4BdR1phzwjhLkK6hDj7GAEbOg-1U-JQFlt895aqn_I4lhZCrnvIlzR1vHlg0HbR_ptYBEzjZABW1mpmgnLbx15GKlbRM7GrNINVYWggyagtOQ2tDqi5bb__5yReLKJP-</recordid><startdate>200001</startdate><enddate>200001</enddate><creator>Spaggiari, Lorenzo</creator><creator>Regnard, Jean-François</creator><creator>Magdeleinat, Pierre</creator><creator>Jauffret, Bertrand</creator><creator>Puyo, Philippe</creator><creator>Levasseur, Philippe</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200001</creationdate><title>Extended resections for bronchogenic carcinoma invading the superior vena cava system</title><author>Spaggiari, Lorenzo ; Regnard, Jean-François ; Magdeleinat, Pierre ; Jauffret, Bertrand ; Puyo, Philippe ; Levasseur, Philippe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-aa2bc623e3696eb5574a3299f3978ef8cc9ec180f8e45b56efbe85dfabbaf2513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Actuarial Analysis</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Brachiocephalic Veins - surgery</topic><topic>Carcinoma, Bronchogenic - secondary</topic><topic>Carcinoma, Bronchogenic - surgery</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Pericardium - transplantation</topic><topic>Pneumonectomy - methods</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Subclavian Vein - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the respiratory system</topic><topic>Survival Rate</topic><topic>Vascular Neoplasms - surgery</topic><topic>Vena Cava, Superior - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spaggiari, Lorenzo</creatorcontrib><creatorcontrib>Regnard, Jean-François</creatorcontrib><creatorcontrib>Magdeleinat, Pierre</creatorcontrib><creatorcontrib>Jauffret, Bertrand</creatorcontrib><creatorcontrib>Puyo, Philippe</creatorcontrib><creatorcontrib>Levasseur, Philippe</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spaggiari, Lorenzo</au><au>Regnard, Jean-François</au><au>Magdeleinat, Pierre</au><au>Jauffret, Bertrand</au><au>Puyo, Philippe</au><au>Levasseur, Philippe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extended resections for bronchogenic carcinoma invading the superior vena cava system</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2000-01</date><risdate>2000</risdate><volume>69</volume><issue>1</issue><spage>233</spage><epage>236</epage><pages>233-236</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. Extended resection of non-small-cell lung cancer (NSCLC) involving the superior vena cava (SVC) system is infrequently performed and oncologic benefits are still uncertain.
Methods. From 1983 to 1996, 25 patients underwent resection of the SVC system for T4, NSCLC.
Results. A total of 12 pneumonectomies (48%), ten lobectomies (40%), and three wedge resections (12%) were performed. Seven patients had complete resection of the SVC with graft interposition, 12 patients underwent tangential resection of the SVC, and 1 patient had a pericardial patch; 5 patients underwent resection of right innominate and subclavian veins without vessel reconstruction. The lymph node status was N0 in 8 patients (32%), N1 in 3 (12%) and N2 in 14 patients (56%). Five patients (20%) underwent incomplete resection. Nine patients (36%) developed postoperative complications (36%) that were fatal in 3 patients (12%). At the completion of the study, 10 patients were still alive. The median survival was 11.5 months and the 5-year actuarial survival rate was 29%, with 4 patients alive at 5 years.
Conclusions. The resection of the SVC system for direct involvement by T4, NSCLC can be performed in selected patients with an acceptable postoperative mortality. Even though no significant prognostic factors were observed, the patients who required a lobectomy with limited lymph node involvement seemed to benefit the most from surgery.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10654520</pmid><doi>10.1016/S0003-4975(99)00867-X</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Actuarial Analysis Adult Aged Biological and medical sciences Blood Vessel Prosthesis Implantation Brachiocephalic Veins - surgery Carcinoma, Bronchogenic - secondary Carcinoma, Bronchogenic - surgery Carcinoma, Non-Small-Cell Lung - surgery Cause of Death Female Follow-Up Studies Humans Lung Neoplasms - surgery Lymphatic Metastasis Male Medical sciences Middle Aged Neoplasm Invasiveness Neoplasm Staging Pericardium - transplantation Pneumonectomy - methods Postoperative Complications Prognosis Retrospective Studies Subclavian Vein - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system Survival Rate Vascular Neoplasms - surgery Vena Cava, Superior - surgery |
| title | Extended resections for bronchogenic carcinoma invading the superior vena cava system |
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