Yale School of Medicine, New Haven, CT 06520, USA.
Eur J Cardiothorac Surg. 2013 Jul;44(1):e66-70. doi: 10.1093/ejcts/ezt184. Epub 2013 Apr 4.
The benefits of salvage resection for lung cancer recurrence following high-dose curative-intent chemoradiation therapy are unclear. We assessed survival after salvage lung resection following definitive chemoradiation.
Medical records of patients undergoing lung cancer resections at our institution following definitive chemoradiation therapy were reviewed from June 2006 to August 2012. A multivariate Cox proportional model was used to assess the factors associated with improved survival.
Fourteen patients had chemoradiation therapy before lung resection (pneumonectomy, lobectomy or segmentectomy). Pretherapy cancer stage was Stage III in 11 patients, Stage IV in 2 and Stage II in 1. Postoperative 2-year survival was 49%. Patients had a median disease-free interval before resection of 33 months. No variables were found to be associated with improved post-chemoradiation survival from the time of definitive treatment or postoperative survival. Complications occurred in 6 (43%) patients, with 2 of those complications directly attributable to post-chemoradiation changes. There were no perioperative deaths within 90 days.
Salvage lung resection for recurrent lung cancer following definitive chemoradiation therapy is feasible and is associated with postoperative survival and complication rates that are reasonable.
高剂量根治性放化疗后肺癌复发行挽救性切除术的获益尚不明确。我们评估了根治性放化疗后行挽救性肺切除术的生存情况。
回顾了 2006 年 6 月至 2012 年 8 月在我院行肺癌切除术且此前接受过根治性放化疗的患者的病历资料。采用多变量 Cox 比例模型评估与生存改善相关的因素。
14 例患者在肺切除术前接受了放化疗（全肺切除术、肺叶切除术或肺段切除术）。11 例患者术前癌症分期为 III 期，2 例为 IV 期，1 例为 II 期。术后 2 年生存率为 49%。患者在接受根治性治疗后至行切除术的无病间隔时间中位数为 33 个月。未发现任何变量与根治性治疗后或术后的生存改善相关。6 例（43%）患者发生并发症，其中 2 例并发症直接归因于放化疗后改变。90 天内无围手术期死亡。
根治性放化疗后复发性肺癌行挽救性肺切除术是可行的，且术后生存和并发症发生率合理。
