PURPOSE: The benefit of surgical therapy of locally advanced non-small cell lung cancer (NSCLC)with infiltration of the superior vena cava (SVC) is still discussed controversially. Our midterm results are presented.
METHODS: A retrospective analysis of 13 patients who underwent SVC resection between 2000 and 2005 was performed( replacement: n=10; partial resection: n=3 ). Ten patients underwent pneumonectomy while the remaining underwent lobar resections. Squamous cell carcinoma was predominat (n=8; adeno: n=3; large cell: n=2). Twelve patients were in stage IIIb and 1 patient in stage IV. Postoperative morbidity and survival were examined.
RESULTS: Median age of the patients was 60 years (47-71). All had direct SVC invasion by the tumor. Median clamp time of the SVC was 32 minutes. There were no neurologic complications.Major postoperative complications were bleeding (n=1),bronchopleural fistula (n=1) and empyema (n=1). Early postoperatively 1 patient died due to sepsis. In the follow up 4 patients died ( cerebral metastasis: n=2; cardial: n=2 ). One-, three- and five-year survival was 61%,40% and 40% respectively. Median survival was 20 months ( 3 to 66 months ).
CONCLUSION: The radical resection of NSCLC involving the SVC in carefully selected patients can be performed with resonable results.
CLINICAL IMPLICATIONS: It remains to be seen, whether modern induction therapy concepts can further improve these results.
DISCLOSURE: Thomas Graeter, None.