This journal is
indexed in Scopus
Year 2012 Vol. 20 No 3
V.V. ZHARKOV, S.A. YESKOV, V.P. KURCHIN
THE LEFT ATRIUM RESECTION IN PATIENTS WITH LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER
SE “N.N.Alexandrov Republican scientific practical center of oncology and radiology”, Minsk
The Republic of Belarus
Objectives. To evaluate the surgical method efficacy while treating patients with non-small cell lung cancer (NSCLC) extending to the intrapericardial sections of the pulmonary veins and/or the left atrium (LA).
Methods. The result analysis of the surgical treatment of 55 patients with locally advanced NSCLC requiring LA resection was carried out in this research. The average age made up 58,4 years (from 38 up to 77 years), median was 59 years. The process was staged as T3N1M0 in 2 cases, as T3N2M0 – in 4 cases, T4N0M0 – in 5 cases, T4N1M0 – in 18 cases, T4N2M0 – in 26 cases. According to the histological structure of the tumor, the patients were divided as follows: the squamous cell carcinoma – 48 (87,3%), adenocarcinoma – (7,3%), the adenosquamous carcinoma – 2, the undifferentiated large cell carcinoma – 1. LA myocardium lesion was noted in 21 cases (38,2%), in the intrapericardial sections of the pulmonary veins – in 34 cases (61,8%). The LA resection was carried out with the help of the linear suturing apparatus in 43 cases, in 2 cases – with vascular clamp. In 10 patients LA resection and its plasty with xenopericardium was done under the conditions of the artificial blood circulation (ABC).
Results. Incidence of the postoperative complications made up 32,7%, postoperative lethality – 10,9%. One-year, three-year and five-year survival rates (n=55) made up 60,9%, 43,3% and 25,1% correspondently, survival rate median – 18,3 months. Among the patients (n=49) with the tumor, classified as pT4N0-2M0, – 62,4%, 33,4% and 27,8% correspondently, survival rate median – 18,3 months. In patients with metastatic lesions of the mediastinal lymph nodes (pT4N2M0, n = 26) five-year survival rate was 29,2%, survival rate median – 18,9 months without mediastinal lymph nodes lesions T4N0-N1 (n = 22) – 21,2% and 16,0 months correspondently (p=0,55).
Conclusions. Surgical method of treatment in patients with NSCLC extending to the heart structures can ensure high long-term survival rate at acceptable frequency parameters of the postoperative complications and postoperative lethality.
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223040, Respublika Belarus', Minskii r-n, p. Lesnoi, 2, GU “RNPTs onkologii i meditsinskoi radiologii im. N.N. Aleksandrova“, otdel torakal'noi onkopatologii s gruppoi anesteziologii,
Eskov Sergey Aleksandrovich
Zharkov V.V. Doctor of Medical Sciences, Professor, Chief Research Fellow of the Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Yeskov S.A., a Research Fellow of the Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Kurchin V.P., Doctor of Medical Sciences, Head of the Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.