초록접수 현황
| 16F-072 | 포럼 발표 |
Feasibility of Lobectomy and Mediastinal node Dissection by Video-assisted Thoracoscopic Surgery Following Neoadjuvant Chemoradiation Therapy for Stage IIIA N2 Non-small Cell Lung Cancer
Yeong Jeong Jeon, Yong Soo Choi
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : We evaluated the feasibility of lobectomy and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC).
Methods : A total of consecutive 35 patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent lobectomy and MND by single surgeon following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcome, postoperative drainage, postoperative complications, recurrence rate and mortality were retrospectively analyzed.
Results : From November 2009 to December 2013, 15 patients with stage IIIA N2 NSCLC underwent lobectomy and MND by VATS (group V) and 20 patients by open thoracotomy (group T). The group V had smaller tumor size (26.6±13.8 vs 39±30.6mm, p = 0.156), lower diffusing capacity for carbon monoxide (DLCO) (77.5±16.5 vs 90.5±18.3%, p < 0.05) and significantly higher proportion of EBUS approach (60 vs 50%, p < 0.05) (Table 1). In five patients, conversion to thoracotomy was required due to anthracofibrotic nodes (4 patients) and tight adhesion (1 patient). The median chest tube duration was 5 days (group V) and 7 days (group T) (Table 2). The median follow-up duration was 35.9 months. The 5-year survival rate was 79.4±10.6% in group V, and 57.3±11.7% in group T (Figure 1). During follow-up, 7 of 15 patients developed recurrence in group V. The pattern of recurrence was loco-regional in 5 patients (1 in ypN0, 6%; 4 in ypN2, 26%) and distant metastasis in 2 (1 in ypN0, 6%; 1 in ypN2, 6%) (Table 3).
Conclusion : The VATS approach following neoadjuvant treatment was feasible to selected patients for treatment of stage IIIA N2 NSCLC without compromising oncologic efficacy. In present study, the patients with the smaller, peripheral tumor, or N2 diagnosed with EBUS tend to be frequently completed VATS.
Methods : A total of consecutive 35 patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent lobectomy and MND by single surgeon following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcome, postoperative drainage, postoperative complications, recurrence rate and mortality were retrospectively analyzed.
Results : From November 2009 to December 2013, 15 patients with stage IIIA N2 NSCLC underwent lobectomy and MND by VATS (group V) and 20 patients by open thoracotomy (group T). The group V had smaller tumor size (26.6±13.8 vs 39±30.6mm, p = 0.156), lower diffusing capacity for carbon monoxide (DLCO) (77.5±16.5 vs 90.5±18.3%, p < 0.05) and significantly higher proportion of EBUS approach (60 vs 50%, p < 0.05) (Table 1). In five patients, conversion to thoracotomy was required due to anthracofibrotic nodes (4 patients) and tight adhesion (1 patient). The median chest tube duration was 5 days (group V) and 7 days (group T) (Table 2). The median follow-up duration was 35.9 months. The 5-year survival rate was 79.4±10.6% in group V, and 57.3±11.7% in group T (Figure 1). During follow-up, 7 of 15 patients developed recurrence in group V. The pattern of recurrence was loco-regional in 5 patients (1 in ypN0, 6%; 4 in ypN2, 26%) and distant metastasis in 2 (1 in ypN0, 6%; 1 in ypN2, 6%) (Table 3).
Conclusion : The VATS approach following neoadjuvant treatment was feasible to selected patients for treatment of stage IIIA N2 NSCLC without compromising oncologic efficacy. In present study, the patients with the smaller, peripheral tumor, or N2 diagnosed with EBUS tend to be frequently completed VATS.
첨부파일 : table.doc
책임저자: Yong Soo Choi
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Yeong Jeong Jeon, E-mail : yj.yj.jeon@samsung.com