[Vertebral en bloc resection for lung cancer: twelve years' experience].
OBJECTIVE
To report a single-institution retrospective study of radical en bloc resection for lung cancer invading the spine.


METHODS
Between 1993 and 2004, 32 patients underwent partial or total vertebrectomy for non-small cells lung cancer with spinal extension. Twenty-one received induction treatment (chemotherapy, N=16; radiation, N=1 and chemoradiotherapy, N=4). Pneumonectomy was performed in 3 patients, lobectomy in 26 patients and wedge resection in 3 patients. Partial vertebrectomy was performed in 26 patients and total vertebrectomy was performed in 6 patients. Tumor stage was IIb in 9 patients, IIIa in 2 patients and IIIb in 21 patients.


RESULTS
There was no immediate postoperative mortality. Major morbidity was observed in 10 patients (31%), including 4 complications related to spinal surgery. For 28 patients, a completed resection was achieved (87%). 2-years survival was 65% and 5-years survival was 24%. Completed resection and induction chemotherapy appear to be determinant prognostics factors (respectively p=0,01 and p=0,04 in univariate analysis).


CONCLUSIONS
Radical en bloc resection with vertebrectomy for lung cancer is technically demanding. Encouraging long-term survival suggest that this surgical approach could be a valid option for selected patients with vertebral involvement of lung cancer.
Chadeyras
J-B
JB
Service de Chirurgie Générale à Orientation Thoracique, CHU Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France. jbchadeyras@gmail.com
Mazel
C
C
Grunenwald
D
D
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011183:Postoperative Complications; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000601:surgery*; D015996:Survival Rate; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
D000970:Antineoplastic Agents