Salvage Surgery for Non-Small Cell Lung Cancer After Definitive Radiotherapy
| Autor: | Hiroshi Date, Yoichi Ohtaki, Toshihiko Iizasa, Kenichi Yoshimura, Kenji Suzuki, Hiroyuki Ito, Masayuki Chida, Morihito Okada, Kimihiro Shimizu, Motohiro Yamashita |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Performance status business.industry medicine.medical_treatment Hazard ratio Perioperative medicine.disease Radiation therapy Interquartile range Medicine Surgery Radiology Stage (cooking) Cardiology and Cardiovascular Medicine business Lung cancer Chemoradiotherapy |
| Zdroj: | The Annals of Thoracic Surgery. 112:862-873 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2020.10.035 |
| Popis: | Background The aim of this study was to describe the characteristics and outcomes of patients with non-small cell lung cancer undergoing salvage surgery after chemoradiotherapy, conventional external beam, stereotactic body radiotherapy, and ion beam radiotherapy. Methods We retrospectively evaluated patients who underwent salvage surgery between 2010 and 2016. Data on perioperative morbidity and mortality and patient outcomes were analyzed. Results In total, 156 patients were included; of those, 110 were categorized into category 1, chemoradiotherapy or conventional external beam; and 46 into category 2, stereotactic body radiotherapy or ion beam radiotherapy. Three-year overall survival (OS) and recurrence-free survival (RFS) in category 1 were 67.3% and 49.8%, respectively. In category 1, pathological nodal stage was an independent prognosticator of both OS (hazard ratio [HR] = 3.53, 95% confidence interval [CI], 1.05-11.83) and RFS (HR = 4.32, 95% CI, 1.32-14.14). In category 2, 3-year OS and RFS were 57.7% and 46.4%, respectively. Age 70 years and greater at initial treatment was the only independent prognosticator of OS (HR = 5.61; 95% CI, 1.44-21.87), whereas age at initial treatment (HR = 6.13; 95% CI, 1.38-27.12) and pathological nodal metastasis (HR = 3.84; 95% CI, 1.40-10.57) were independent prognosticators for RFS. Overall 30- and 90-day mortality were 0% and 0.9% in category 1 and 0% and 4.3% in category 2, respectively. Conclusions Patients who undergo salvage surgery can have reasonable outcomes, and salvage surgery can be considered in selected patients. |
| Databáze: | OpenAIRE |
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