Pulmonary resections following prior definitive chemoradiation therapy are associated with acceptable survival

Eur J Cardiothorac Surg. 2013 Jul;44(1):e66-70. doi: 10.1093/ejcts/ezt184. Epub 2013 Apr 4.

Abstract

Objectives: The benefits of salvage resection for lung cancer recurrence following high-dose curative-intent chemoradiation therapy are unclear. We assessed survival after salvage lung resection following definitive chemoradiation.

Methods: Medical records of patients undergoing lung cancer resections at our institution following definitive chemoradiation therapy were reviewed from June 2006 to August 2012. A multivariate Cox proportional model was used to assess the factors associated with improved survival.

Results: Fourteen patients had chemoradiation therapy before lung resection (pneumonectomy, lobectomy or segmentectomy). Pretherapy cancer stage was Stage III in 11 patients, Stage IV in 2 and Stage II in 1. Postoperative 2-year survival was 49%. Patients had a median disease-free interval before resection of 33 months. No variables were found to be associated with improved post-chemoradiation survival from the time of definitive treatment or postoperative survival. Complications occurred in 6 (43%) patients, with 2 of those complications directly attributable to post-chemoradiation changes. There were no perioperative deaths within 90 days.

Conclusions: Salvage lung resection for recurrent lung cancer following definitive chemoradiation therapy is feasible and is associated with postoperative survival and complication rates that are reasonable.

Keywords: Lung neoplasms; Pneumonectomy; Salvage therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chemoradiotherapy
  • Female
  • Humans
  • Lung Neoplasms* / epidemiology
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / therapy
  • Male
  • Middle Aged
  • Pneumonectomy
  • Postoperative Complications
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Survival Analysis