초록접수 현황
| 15F-105 | 구연 발표 |
Predictors of Surgical Outcomes in Locally Advanced Non-small-cell Lung Cancer Invading the Great Vessels and Left Atrium
박병준, 신수민, 조종호, 김홍관, 최용수, 조재일, 심영목, 김진국
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
Background : The aim of this study was to analyze the surgical outcomes and prognostic factors of patients with locally advanced lung cancer with invasion of the great vessels or the heart.
Methods : Fifty patients who were surgically treated and pathologically diagnosed with T4N0-1 non-small-cell lung cancer with invasion to the great vessels or the left atrium were enrolled. Patients with neoadjuvant therapy were excluded.
Results : Complete resection was achieved in 45 patients (90%). Pneumonectomy was performed in 30 patients (60%). In-hospital mortality was 8% and 5-year overall and disease-free survival rate was 44% and 40%, respectively. The 5-year overall survival according to the site of invasion were 20.0% for left atrium (n =10), 66.7% for aorta (n = 9), 60% for superior vena cava (n = 5), 47.4% for main pulmonary artery (n = 20), and 44.4% for pulmonary vein (n = 6). In multivariate analysis, right sided cancer (p = 0.009), grossly incomplete resection (R2; p = 0.046), pneumonectomy (p = 0.021), and large cell neuroendocrine cancer (p < 0.001) were predictors for overall survival, and right sided cancer (p = 0.046), left atrial invasion (p = 0.014), number of metastatic lymph node (p = 0.013), and large cell neuroendocrine cancer (p = 0.001) for disease-free survival. Patients with left atrial invasion tended to have distant recurrence more frequently (p = 0.077) than other involved sites.
Conclusion : Surgical resection of locally advanced lung cancer involving cardiovascular structures yielded acceptable clinical outcomes, with the exception of patients with left-atrial invasion.
Methods : Fifty patients who were surgically treated and pathologically diagnosed with T4N0-1 non-small-cell lung cancer with invasion to the great vessels or the left atrium were enrolled. Patients with neoadjuvant therapy were excluded.
Results : Complete resection was achieved in 45 patients (90%). Pneumonectomy was performed in 30 patients (60%). In-hospital mortality was 8% and 5-year overall and disease-free survival rate was 44% and 40%, respectively. The 5-year overall survival according to the site of invasion were 20.0% for left atrium (n =10), 66.7% for aorta (n = 9), 60% for superior vena cava (n = 5), 47.4% for main pulmonary artery (n = 20), and 44.4% for pulmonary vein (n = 6). In multivariate analysis, right sided cancer (p = 0.009), grossly incomplete resection (R2; p = 0.046), pneumonectomy (p = 0.021), and large cell neuroendocrine cancer (p < 0.001) were predictors for overall survival, and right sided cancer (p = 0.046), left atrial invasion (p = 0.014), number of metastatic lymph node (p = 0.013), and large cell neuroendocrine cancer (p = 0.001) for disease-free survival. Patients with left atrial invasion tended to have distant recurrence more frequently (p = 0.077) than other involved sites.
Conclusion : Surgical resection of locally advanced lung cancer involving cardiovascular structures yielded acceptable clinical outcomes, with the exception of patients with left-atrial invasion.
책임저자: 김진국
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
연락처 : 박병준, Tel: 02-2148-1696 , E-mail : bj80.park@samsung.com
