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Erschienen in: General Thoracic and Cardiovascular Surgery 10/2022

28.03.2022 | Original Article

Safety and efficacy of salvage surgery for non-small cell lung cancer: a retrospective study of 46 patients from four Keio-affiliated hospitals

verfasst von: Shigeki Suzuki, Keisuke Asakura, Masayuki Okui, Makoto Sawafuji, Takao Shigenobu, Atsushi Tajima, Kaoru Kaseda, Kyohei Masai, Tomoyuki Hishida, Hisao Asamura

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 10/2022

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Abstract

Objectives

Advances in drug therapy and radiotherapy for non-small cell lung cancer resulted in an increased number of salvage surgeries for initially unresectable tumors. This study aimed to evaluate the safety and efficacy of salvage surgery for non-small cell lung cancer.

Methods

We defined salvage surgery as (1) surgery for local recurrence/residual tumor after definitive chemoradiotherapy/radiotherapy (salvage surgery in a narrow sense) or (2) conversion surgery after non-surgical treatment. We retrospectively analyzed patients who underwent salvage surgery at four Keio University-affiliated hospitals.

Results

Forty-six patients were included. The initial clinical stage was I in 4 patients (9%), III in 19 (41%), and IV in 23 (48%). Initial treatment before salvage surgery was chemoradiotherapy in 10 patients (24%), radiotherapy in 4 (9%), and drug therapy in 32 (67%). Pneumonectomy, lobectomy, segmentectomy, and wedge resection were performed in 2 (4%), 37 (80%), 3 (7%), and 4 (9%) patients, respectively. Complete resection was achieved in 41 patients (89%). Postoperative complications occurred in 11 patients (24%). Initial chemoradiotherapy/radiotherapy was an independent predictor of postoperative complications (odds ratio 10, p = 0.03). The 30- and 90-day mortality rates were 0 and 2%, respectively. The 5-year overall and progression-free survival rates were 66 and 30%, respectively.

Conclusion

The safety and efficacy of salvage surgery for non-small cell lung cancer were acceptable. Salvage surgery was a viable treatment option for selected patients with recurrent/residual tumors after non-surgical treatments.
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Metadaten
Titel
Safety and efficacy of salvage surgery for non-small cell lung cancer: a retrospective study of 46 patients from four Keio-affiliated hospitals
verfasst von
Shigeki Suzuki
Keisuke Asakura
Masayuki Okui
Makoto Sawafuji
Takao Shigenobu
Atsushi Tajima
Kaoru Kaseda
Kyohei Masai
Tomoyuki Hishida
Hisao Asamura
Publikationsdatum
28.03.2022
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 10/2022
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-022-01808-4

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