A Multicenter Retrospective Cohort Study on Superior Vena Cava Resection in Non-Small-Cell Lung Cancer Surgery.
T4 tumor
locally advanced NSCLC
prosthesis
superior vena cava involvement
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
13 Dec 2022
13 Dec 2022
Historique:
received:
03
11
2022
revised:
07
12
2022
accepted:
10
12
2022
entrez:
23
12
2022
pubmed:
24
12
2022
medline:
24
12
2022
Statut:
epublish
Résumé
Surgery for non-small-cell lung cancers (NSCLCs) invading the superior vena cava (SVC) is rarely performed due to surgical complexities and reported poor prognoses. Different methods have been described to reconstruct the SVC, such as direct suture, patch use or prosthesis, according to its circumferential involvement. The aim of our study was to analyze the short- and long-term results of different types of SVC resection and reconstruction for T4 NSCLCs. Between January 2000 and December 2019, 80 patients received an anatomical lung resection with SVC surgery in this multicenter retrospective study. The partial resection and direct suture or patch reconstruction group included 64 patients, while the complete resection and prosthesis reconstruction group included 16 patients. The primary endpoints were as follows: long-term survival and disease-free survival. The secondary endpoints were as follows: perioperative complications and 30- and 90-day mortality. Unpaired t-tests or Mann-Whitney U tests for non-parametric variables were applied to discrete or continuous data, and the chi-square test was applied to dichotomous or categorical data. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test. No differences were found between the two groups in terms of general characteristics and surgical, oncological and survival outcomes. In particular, there were no differences in terms of early (50.0% vs. 68.8%, According to our results, SVC resection has good oncological and survival outcomes, regardless of the proportion of circumferential involvement and the type of reconstruction.
Sections du résumé
BACKGROUND
BACKGROUND
Surgery for non-small-cell lung cancers (NSCLCs) invading the superior vena cava (SVC) is rarely performed due to surgical complexities and reported poor prognoses. Different methods have been described to reconstruct the SVC, such as direct suture, patch use or prosthesis, according to its circumferential involvement. The aim of our study was to analyze the short- and long-term results of different types of SVC resection and reconstruction for T4 NSCLCs.
METHODS
METHODS
Between January 2000 and December 2019, 80 patients received an anatomical lung resection with SVC surgery in this multicenter retrospective study. The partial resection and direct suture or patch reconstruction group included 64 patients, while the complete resection and prosthesis reconstruction group included 16 patients. The primary endpoints were as follows: long-term survival and disease-free survival. The secondary endpoints were as follows: perioperative complications and 30- and 90-day mortality. Unpaired t-tests or Mann-Whitney U tests for non-parametric variables were applied to discrete or continuous data, and the chi-square test was applied to dichotomous or categorical data. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test.
RESULTS
RESULTS
No differences were found between the two groups in terms of general characteristics and surgical, oncological and survival outcomes. In particular, there were no differences in terms of early (50.0% vs. 68.8%,
CONCLUSIONS
CONCLUSIONS
According to our results, SVC resection has good oncological and survival outcomes, regardless of the proportion of circumferential involvement and the type of reconstruction.
Identifiants
pubmed: 36551624
pii: cancers14246138
doi: 10.3390/cancers14246138
pmc: PMC9776451
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Ann Thorac Cardiovasc Surg. 2018 Jun 20;24(3):131-138
pubmed: 29681596
Ann Thorac Surg. 2009 Aug;88(2):392-7
pubmed: 19632380
Ann Thorac Surg. 2008 Oct;86(4):1065-75; discussion 1074-5
pubmed: 18805134
Surg Today. 2016 Dec;46(12):1421-1426
pubmed: 27300545
Ann Thorac Surg. 2000 Jan;69(1):233-6
pubmed: 10654520
Lung Cancer. 2007 May;56(2):223-7
pubmed: 17229487
Ann Thorac Surg. 2007 Jan;83(1):223-9; discussion 229-30
pubmed: 17184668
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
Eur J Cardiothorac Surg. 1994;8(4):177-82
pubmed: 8031559
Int J Surg. 2019 Dec;72:156-165
pubmed: 31704426
J Thorac Cardiovasc Surg. 1991 Aug;102(2):259-65
pubmed: 1865699
Thorac Surg Clin. 2014 Nov;24(4):457-64
pubmed: 25441139
Eur J Cardiothorac Surg. 2021 Nov 2;60(5):1195-1200
pubmed: 34198335
Value Health. 2017 Mar;20(3):487-495
pubmed: 28292495
Mayo Clin Proc. 2019 Aug;94(8):1623-1640
pubmed: 31378236
Eur J Cardiothorac Surg. 2009 Apr;35(4):718-23; discussion 723
pubmed: 19233668
Eur J Cardiothorac Surg. 2002 Jun;21(6):1080-6
pubmed: 12048089
Lung Cancer. 2004 Sep;45(3):357-63
pubmed: 15301876
Clin Ther. 2020 Jan;42(1):25-33
pubmed: 31932079