title: Resection of locally advanced (T4) non-small cell lung cancer with cardiopulmonary bypass.
abstract: BACKGROUND
  Resection of T4 non-small cell lung cancer (NSCLC) on cardiopulmonary bypass (CPB) has rarely been reported in the literature. Hence, we have reviewed our experience in the role of CPB for the surgical treatment of locally advanced NSCLC.
  
  
  METHODS
  All patients undergoing lung resection for bronchogenic carcinoma on CPB in our institution between January 1998 and June 2004 were reviewed.
  
  
  RESULTS
  Seven patients underwent lung resections on CPB for bronchogenic carcinoma during the study period. Cardiopulmonary bypass was performed for tumors invading the subclavian artery down to the aortic arch (n = 2), the descending aorta (n = 1), or the origin of the left pulmonary artery with the left atrium (n = 2). All patients were discharged home after 9 to 21 days (median, 15 days). In the long term, 2 patients are alive without recurrence 17 and 25 months after their operations, and 3 are alive with recurrence 8, 13, and 54 months postoperatively. Two additional patients required CPB while undergoing carinal resection for difficulty ventilating the left lung. Both patients had a difficult postoperative course, but were eventually discharged from hospital. One patient died without recurrence 6 months later, and the other is alive without recurrence after 72 months.
  
  
  CONCLUSIONS
  This study confirms the safety of CPB for NSCLC invading the great vessels and/or the left atrium in well-selected patients, and its utility when pulmonary edema develops during carinal resection. Further studies, however, are required to confirm long-term survival.
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.
authors.forename: Marc
authors.initials: M
authors.lastname: de Perrot
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.forename: Sacha
authors.initials: S
authors.lastname: Mussot
authors.forename: Angela
authors.initials: A
authors.lastname: de Palma
authors.forename: Alain
authors.initials: A
authors.lastname: Chapelier
authors.forename: Philippe
authors.initials: P
authors.lastname: Dartevelle
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery; D016896:Treatment Outcome