En bloc partial vertebrectomy for lung cancer invading the spine after induction chemoradiotherapy.
OBJECTIVE
The optimal surgical treatment for non-small cell lung cancer (NSCLC) with vertebral body invasion remains both controversial and challenging. We reviewed our experiences of NSCLC with vertebral body invasion, in which we have performed induction chemoradiotherapy followed by lung resection with en bloc partial vertebrectomy.


METHODS
Six NSCLC patients with vertebral invasion underwent an operation following chemoradiotherapy from January 2001 to July 2006. Vertebral invasion was evaluated by the chest CT and MRI findings. Either carboplatin-paclitaxel (n=3) or carboplatin-docetaxel (n=3) was used. Two cycles of chemotherapy were performed with concurrent radiation (50 Gy) treatment.


RESULTS
In all of the six cases, a complete resection with en bloc partial vertebrectomy was performed with no operative mortality. The histological complete response rate and major response rate were 16.7% (1/6) and 83.3% (5/6), respectively. The 5-year overall survival rate was 67.7%. In addition, no local failure was observed after surgery.


CONCLUSIONS
Surgery after chemoradiotherapy (carboplatin/paclitaxel or docetaxel and 50 Gy radiation) for NSCLC with vertebral invasion could thus be performed with acceptable morbidity.
Yokomise
Hiroyasu
H
2nd Department of Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. yokomise@kms.ac.jp
Gotoh
Masashi
M
Okamoto
Taku
T
Yamamoto
Yasumichi
Y
Ishikawa
Shinya
S
Liu
Dage
D
Oka
Shiro
S
Huang
Cheng-Long
CL
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery / Q000628:therapy; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013125:Spinal Neoplasms / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D016019:Survival Analysis; D019616:Thoracic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome