Novosti
Khirurgii

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Year 2016 Vol. 24 No 4

ONCOLOGY

V.V. ZHARKOV 1, S.A. YESKOV 2, V.V. EROKHOV 2

SURGICAL TREATMENT RESULTS OF PATIENTS WITH LOCALLY ADVANCED (PT4) NON-SMALL CELL LUNG CANCER

SE "Republican Scientific-Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov"1,
ME "The 9th City Clinical Hospital"2,
Minsk
The Republic of Belarus

Objectives. To evaluate the immediate and long-term results of surgical treatment of patients with locally advanced non-small cell lung cancer (NSCLC – stage IIIA-IIIB) accompanied by mediastinal invasion of the tumor.
Methods. 180 surgeries had been performed (1996-2012 yrs) to the patients with locally advanced pT4 NSCLC. The age varied from 21 up to 81, the median age – 58. The right-sided tumor was registered in 103 cases and left-sided – in 77. The pT4 descriptor was determined on the basis of the lung cancer invasion of different structures or mediastinal organs. Affection of two or more structures occurred in 77 cases. The disease was staged as pT4N0M0 in 23 cases, pT4N1M0 – in 54, pT4N2M0 – in 103. Surgical interventions such as combined lobectomy or bilobectomy were performed only in 5 patients, and combined pneumonectomy – in 175, including 34 cases – the carinal wedge resection of tracheal bifurcation and 42 – sleeve resection. Resection of the vena cava superior was performed in 36 patients. The aorta was resected in 27 cases, the left atrium – in 70, the esophagus – in 31, the vertebrae – in 8 patients; ribs were resected in 18 cases.
Results. The postoperative morbidity was 33,9%, mortality – 17,8%. Overall five-year survival rate of patients with stages IIIA-IIIB (pT4N0-2M0) was 19,8%, median survival – 14,9 months. In the group of IIIA (pT4N0-1M0) stage – 26,0%, 22,7 months, respectively. In the group of patients with metastatic mediastinal lymph nodes (pT4N2M0) – 14,7%, 13,6 months, respectively (p=0,038).
Conclusion. Combined surgery allows achieving satisfactory immediate and long-term results of treatment at the admissible indices of postoperative mortality. The best results can be obtained for patients with stage IIIA (pT4N0-1M0) NSCLC.

Keywords: non-small cell lung cancer, locally advanced lung cancer, combined surgeries, overall survival, morbidity, mortality, postoperative period
p. 385-393 of the original issue
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Address for correspondence:
220116, Republic of Belarus, Minsk, Semashko st., 8, ME "9th
City Clinical Hospital", thoracic department.
Tel: 375 29 115-77-36
E-mail: 445e@mail.ru
Yeskov Sergey Aleksandrovich
Information about the authors:
Zharkov V.V. MD, Professor, Head "Republican scientific-practical center of oncology and medical radiology named after N.N. Alexandrov", surgical department.
Yeskov S.A. Head, ME "The 9th city clinical hospital", thoracic department.
Erokhov V.V. Surgeon, ME "The 9th city clinical hospital", thoracic department.
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