Mortality Clinical Trial
Official title:
Short and Long Term Outcomes of Patients With Locally Advanced Non-Small Cell Lung Cancer Undergoing Pulmonary Parenchyma Resection After Induction Treatment.
Surgery still remains the main treatment option for Non-Small Cell Lung Cancer (NSCLC) which is limited within the lung parenchyma and possibly invades the intrapulmonary or hilar nodes. The role of surgery in locally advanced NSCLC with the form of invasion of adjacent strictures or mediastinal nodes is a 30-year point of discussion and debate among thoracic surgeons, clinical and radiation oncologists, chest physicians and other related specialties. Despite the continuous debate the management of locally advanced NSCLC varies between different countries and different institutions.We try to investigate the short and long term outcomes of surgery after induction treatment performed for locally advanced NSCLC.
All patients who underwent surgery with curative intent or salvage after induction treatment
during a 8-year time period (2011-2019). Induction treatment with the form either of
chemotherapy or chemoradiotherapy was delivered according to the thoracic multidisciplinary
team decision which it was based on primary tumor histology and stage. Patients with Pancoast
tumors were excluded from the study design, because these tumors have different clinical
characteristics and represent a separate category of NSCLC with a well recognized specific
treatment plan worldwide.
Overall 42 patients are included in the study and the recorded parameters in each patient
are:
1. Age, gender, comorbidities, histology, location in the lung and stage of tumor at
presentation, tools used for preoperative staging in each case, any previous surgical
procedures of other treatments performed before elsewhere, type of induction treatment,
tools used for tumor restaging.
2. In each patient were recorded any specific technical details concerning the applied
surgical procedures, time of surgery and one-lung ventilation (OLV), postoperative
complications and their management, mortality, pos-resection staging (ypTNM), the number
of resected lymph nodes in each patient.
3. Concerning the long term outcomes, overall and disease-free survival, kind of recurrence
(local, distant, combination) and treatment of recurrences were recorded.
Interpretation fo the results will include the correlation of surgical details, kind and dose
of induction treatment with postoperative complications, especially infectious complications
and prolonged air leaks. Radicality of the resection and response of the tumor to induction
treatment (ypTNM stage) as it is recorded in histology reports are the two important clinical
parameters to be studied for their effect on long term survival and recurrences.
Surgery was applied as salvage surgery in not well responded tumors or as resection of
downstaged tumors.
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