Abstract | BACKGROUND: METHODS: RESULTS: Twelve patients, including 10 males and 2 females with median age 63.5 years, were referred. Clinical stage was IB (1 patient), IIB (2 patients), IIIA (8 patients), and IIIB (1 patient). There were no disease progression after neoadjuvant chemoradiotherapy, and all patients underwent curative resection. For 8 patients, pneumonectomy was avoided, with 3 bronchoplasties and 3 pulmonary arterial angioplasties. We had 4 pneumonectomies: three cases of metastatic enlarged lymph nodes invading either the carina or a more central portion of the pulmonary artery than the left A3 branch or vein which needs incision of the inner pericardium and 1 case with a tumor involving the upper lobe bronchus to the inferior lobe bronchus. There were no postoperative deaths and 1 case of bronchopleural fistula. The 5-year disease-free and overall survival rates were 55.6 and 72.7% without stump or anastomotic recurrence. CONCLUSIONS:
Neoadjuvant chemoradiotherapy for centrally located NSCLC appeared to be a useful treatment option for avoiding pneumonectomy without impairing curability and safety, especially in highly selected cases without invasion to carina or right-or-left main trunk of pulmonary artery or vein at pretreatment.
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Authors | Keizo Misumi, Hiroaki Harada, Norifumi Tsubokawa, Yasuhiro Tsutani, Kotaro Matsumoto, Yoshihiro Miyata, Yoshinori Yamashita, Morihito Okada |
Journal | General thoracic and cardiovascular surgery
(Gen Thorac Cardiovasc Surg)
Vol. 65
Issue 7
Pg. 392-399
(Jul 2017)
ISSN: 1863-6713 [Electronic] Japan |
PMID | 28432576
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Aged
- Antineoplastic Agents
(therapeutic use)
- Carcinoma, Non-Small-Cell Lung
(diagnosis, mortality, therapy)
- Chemoradiotherapy
(methods)
- Female
- Humans
- Japan
(epidemiology)
- Lung Neoplasms
(diagnosis, mortality, therapy)
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Staging
- Pneumonectomy
- Retrospective Studies
- Survival Rate
(trends)
- Tomography, X-Ray Computed
- Treatment Outcome
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