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Eur J Cardiothorac Surg 2007;31:788-790. doi:10.1016/j.ejcts.2007.01.062
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

En bloc partial vertebrectomy for lung cancer invading the spine after induction chemoradiotherapy

Hiroyasu Yokomisea,*, Masashi Gotoha, Taku Okamotoa, Yasumichi Yamamotoa, Shinya Ishikawaa, Dage Liua, Shiro Okab, Cheng-long Huanga

a The 2nd Department of Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
b Department of Orthopedic Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kita-gun, Kagawa 761-0793, Japan

Received 10 December 2006; received in revised form 30 January 2007; accepted 31 January 2007.

* Corresponding author. Tel.: +81 87 891 2191; fax: +81 87 891 2192. (Email: yokomise{at}kms.ac.jp).

Objective: The optimal surgical treatment for non-small cell lung cancer (NSCLC) with vertebral body invasion remains both controversial and challenging. We reviewed our experiences of NSCLC with vertebral body invasion, in which we have performed induction chemoradiotherapy followed by lung resection with en bloc partial vertebrectomy. Methods: Six NSCLC patients with vertebral invasion underwent an operation following chemoradiotherapy from January 2001 to July 2006. Vertebral invasion was evaluated by the chest CT and MRI findings. Either carboplatin–paclitaxel (n = 3) or carboplatin–docetaxel (n = 3) was used. Two cycles of chemotherapy were performed with concurrent radiation (50 Gy) treatment. Results: In all of the six cases, a complete resection with en bloc partial vertebrectomy was performed with no operative mortality. The histological complete response rate and major response rate were 16.7% (1/6) and 83.3% (5/6), respectively. The 5-year overall survival rate was 67.7%. In addition, no local failure was observed after surgery. Conclusions: Surgery after chemoradiotherapy (carboplatin/paclitaxel or docetaxel and 50 Gy radiation) for NSCLC with vertebral invasion could thus be performed with acceptable morbidity.

Key Words: En bloc partial vertebrectomy • Induction chemoradiotherapy • T4 non-small-cell lung cancer




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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.