Combined resection of great vessels or the heart for non-small lung cancer.
OBJECTIVE
The surgical indications for non-small cell lung cancer (NSCLC) infiltrating a great vessel or the heart are controversial. We assessed clinical features and surgical outcomes of patients with non-small cell lung cancer who underwent combined resection of a lung and great vessel.


METHODS
Fourteen patients underwent great vessel resection under a lobectomy (n = 9), sleeve lobectomy (n = 2), or pneumonectomy (n = 3) between 2000 and 2011, in whom the aorta was resected in 6, superior vena cava in 5, right atrium in 1, and left atrium in 2. The histological types were adenocarcinoma (n = 8) and squamous cell carcinoma (n = 6).


RESULTS
Complete resection was performed in 12 patients. Of all patients, 7 had pN0 disease, 2 had pN1, and 4 had pN2. The postoperative morbidity rate was 28.6% and mortality rate was 7.1%. The 5-year survival rate was 26.8% for all patients, 46.9% for those with an adenocarcinoma, 0% for those with a squamous cell carcinoma, 53.6% for those with pN0, and 0% for those with pN1-2.


CONCLUSIONS
Resection of the great vessels and heart involved by NSCLC can be performed with acceptable morbidity and mortality, and results in prolonged survival in patients, with an adenocarcinoma or N0 status.
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Hidenori
H
Kusumoto
Yasushi
Y
Shintani
Soichiro
S
Funaki
Masayoshi
M
Inoue
Meinoshin
M
Okumura
Toru
T
Kuratani
Yoshiki
Y
Sawa
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001011:Aorta / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D059248:Chemoradiotherapy / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery*