| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2003;23:229-232
© 2003 Elsevier Science NL
Oncologia Chirurgica Toracica, Istituto Nazionale Tumori, Via Venezian 1, 20133 Milan, Italy
Received 18 September 2001; received in revised form 1 November 2002; accepted 5 November 2002.
* Corresponding author. Tel.: +39-02-2390-2788; fax: +39-02-2360-486
e-mail: lequaglie{at}istitutotumori.mi.it
Objective: This retrospective study evaluates the survival impact of the residual margin disease after bronchial resection for cancer and suggests tactics in cases of microresidual disease. Methods: Between March 1988 and 1998, 4530 consecutive patients underwent surgery for non-small cell lung cancer at our institution. Only incomplete resections after microscopic evaluation (R1) were included in the study. Residual tumour cells were found on the bronchial resection margins of 39 lobectomies, 12 pneumonectomies, 4 segmental resections and one bilobectomy. Histological findings were: squamous cell carcinoma in 38 cases, adenocarcinoma in 15 and large cell carcinoma in three. In all 56 cases, invasive mucosal carcinoma was found exclusively on the bronchial resection margin. Nineteen tumours were stage I; 12, stage II; 17, stage IIIa; 5, stage IIIb; and three, stage IV. Nineteen patients (59.3%) with early stage tumours (I and II) received adjuvant radiation therapy and only three chemotherapy. Results: The prognosis in these cases was disease-stage related (21 and 38.4% of deaths due to the disease). Forty-one percent of the stage IIIa patients received radiation therapy and 17.6% chemotherapy: 70.6% died of tumour relapse. Forty percent of the stage IIIb patients received radiation therapy and 20% chemotherapy: 60% died of disease progression. All of the stage IV patients died within 3 months from surgical resection. At the end of the study, 21 patients were alive after an interval of 22–142 months (18 in stage I or II). The 10-year actuarial survival rate was 44%. The percentage survival for stage IIIa was 16.8, after 10 years, and fell to 45 months for stage IIIb. Conclusions: The prognosis of our stage I or II patients with microresidual tumour on the bronchial resection margin (R1) was similar to that of the patients in the same disease stage, whose resection was microscopically radical (R0) and the same was true of the patients in stage III. In patients with residual tumour cells on the bronchial stump we did not observe worsened long-term survivals.
Key Words: Lung cancer • Surgery • Resection margin • Incomplete resection • Survival
This article has been cited by other articles:
|
|
 |
|
  J. Wind, E. J. Smit, S. Senan, and J.-P. Eerenberg Residual disease at the bronchial stump after curative resection for lung cancer Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 29 - 34. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Balasubramanian, J. Au, and J. Dunning Should lobectomy patients with microscopic involvement of the bronchial resection margin undergo re-operation to improve their long-term survival? Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 531 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pasic, K. Grunberg, W. J. Mooi, M. A. Paul, P. E. Postmus, and T. G. Sutedja The Natural History of Carcinoma In Situ Involving Bronchial Resection Margins Chest, September 1, 2005; 128(3): 1736 - 1741. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Guo, M. G. House, C. Hooker, Y. Han, E. Heath, E. Gabrielson, S. C. Yang, S. B. Baylin, J. G. Herman, and M. V. Brock Promoter Hypermethylation of Resected Bronchial Margins: A Field Defect of Changes? Clin. Cancer Res., August 1, 2004; 10(15): 5131 - 5136. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
