Short and Long Term Outcomes of Patients With Locally Advanced Non-Small Cell Lung Cancer Undergoing Pulmonary Parenchyma Resection After Induction Treatment.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Patient Outcome Assessment
- Sponsor
- AHEPA University Hospital
- Enrollment
- 42
- Primary Endpoint
- Recurrence of tumor - Disease free survival
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Christophoros N. Foroulis
Associate Professor of Thoracic Surgery
AHEPA University Hospital
Eligibility Criteria
Inclusion Criteria
- •Patients who underwent surgery for NSCLC after induction treatment
Exclusion Criteria
- •Patients who underwent surgery fo NSCLC located in the superior sulcus and Pancoast syndrome.
Outcomes
Primary Outcomes
Recurrence of tumor - Disease free survival
Time Frame: From date of surgery to up to 96 months after surgery
Close clinical follow-up by clinical oncologists and surgeons to detect and treat recurrences. Correlation of recurrences with post-resection (ypTNM) stage of tumor, completeness of resection, type of surgical procedure
Mortality-Morbidity
Time Frame: From date of surgery until 12 weeks after surgery
Mortality and morbidity of the pulmonary parenchyma resection for NSCLC after induction treatment
Long term survival of patients and correlation of long term survival with the post-resection stage of tumor (ypTNM stage)
Time Frame: From the date of surgery to up to 96 months after surgery
Close clinical follow-up by clinical oncologists and surgeons to detect and treat
Secondary Outcomes
- Postoperative complications(From time of surgery to up to 12 weeks after surgery)
- Specific details concerning the surgical procedures and correlation with morbidity(From time of surgery to up to 12 weeks after surgery)
- Respiratory complications(From time of surgery to up to 12 weeks after surgery)