Objective: We reviewed our 8-year experience with en bloc partial and total vertebrectomy for lung cancer invading the spine and report outcome and survival.
Methods: Nineteen patients with lung cancers involving the spine underwent en bloc resection. Eleven received induction treatment (chemotherapy, n = 5; chemoradiotherapy, n = 4; and radiation, n = 2). Pneumonectomy was performed in 3 patients, lobectomy in 13 patients, and wedge resection in 3 patients. Hemivertebrectomy was performed in 15 patients, and total vertebrectomy was performed in 4 patients. The median number of resected vertebral bodies was 3 (range, 1-4). Tumor stage was IIIB in 14 patients, IIIA in 1 patient, and IIB in 4 patients (hemivertebrectomy is performed in the case of T3 disease to obtain free margins). Surgical nodal status was N0 in 13 patients, N1 in 3 patients, N2 in 1 patient, and N3 (supraclavicular) in 2 patients. Complete macroscopic and microscopic resection was achieved in 15 (79%) patients.
Results: There was no immediate postoperative mortality. Morbidity was observed in 10 patients, including 4 (21%) complications related to the spinal surgery. The median hospital stay was 30 days. Seven patients were alive after a mean follow-up of 26 months (range, 7-74 months). The 1- and 5-year predicted survivals (updated) are 59% and 14%, respectively. Nine local recurrences were observed.
Conclusions: En bloc resection of chest tumors with vertebrectomy is technically demanding, and postoperative morbidity should be critically addressed with this aggressive surgical intervention. However, an encouraging long-term survival observed in this series suggests that en bloc resection could be a valid option in selected patients with vertebral involvement of chest tumors.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1067/mtc.2002.119333 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Arterial thoracic outlet syndrome caused by a cervical rib: a combined thoracoscopic and supraclavicular approach for "en bloc"-resection.
Interdiscip Cardiovasc Thorac Surg
December 2024
Department of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
A cervical rib is the cause of about 5% of thoracic outlet syndromes (TOS). We report the case of a patient with arterial TOS due to the presence of a cervical rib, managed by combined thoracoscopic and supraclavicular approach. An 18 years old female patient presented with symptoms of arterial TOS.
View Article and Find Full Text PDFClinical results of knee juxta-articular giant-cell tumors treated with bone cement filling and internal fixation after extensive curettage.
Jt Dis Relat Surg
January 2025
Department of Orthopaedics, Changzhou Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu Province, China.
Objectives: This study was to evaluate the radiological and clinical outcomes of patients with juxta-articular giant-cell tumors (GCTs) around the knee treated with bone cement filling and internal fixation after extensive curettage.
Patients And Methods: A total of 15 patients (6 males, 9 females; mean age: 35.3±8.
Hepatectomy with Hepatic Vein Resection and Reconstruction Under Total Vascular Exclusion and Venous Drainage via a Venovenous Bypass: An Additional Approach for Complex Hepatectomies.
Ann Surg Oncol
December 2024
Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Hépatiques et Digestives, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
Background: Total vascular exclusion (TVE) with liver hypothermic perfusion under venovenous bypass (VVB) is usually needed to perform hepatectomy with Inferior vena cava and hepatic veins resection-reconstruction. An alternative technique is represented by liver resection under intermittent pedicular clamping, IVC total clamping and VVB, without cold perfusion and liver outflow drainage through the VVB. PATIENTS AND METHODS: The patient is a 60-year-old woman with past medical history of right hepatectomy for leiomyosarcoma 14 years previously.
View Article and Find Full Text PDFChallenges, Treatment Strategies, and Surgical Techniques in the Management of Spermatic Cord Sarcomas.
Ann Surg Oncol
December 2024
Soft Tissue Sarcoma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Spermatic cord sarcomas (SCS) are a group of mesenchymal tumors whose rarity and anatomical location often lead to clinical misdiagnosis such as inguinal hernia, testicular tumor, or other conditions. Any inguinoscrotal mass with suspicious characteristics should prompt clinicians to perform imaging assessments (such as ultrasound or, in uncertain cases, magnetic resonance imaging (MRI)) and refer the patient promptly to a specialized center. Histological characterization of all suspicious masses via percutaneous biopsy is recommended, with staging completed through computed tomography (CT) scan for confirmed cases.
View Article and Find Full Text PDFAGA Clinical Practice Update on Screening and Surveillance in Individuals at Increased Risk for Gastric Cancer in the United States: Expert Review.
Gastroenterology
December 2024
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California.
Description: Gastric cancer (GC) is a leading cause of preventable cancer and mortality in certain US populations. The most impactful way to reduce GC mortality is via primary prevention, namely Helicobacter pylori eradication, and secondary prevention, namely endoscopic screening and surveillance of precancerous conditions, such as gastric intestinal metaplasia (GIM). An emerging body of evidence supports the possible impact of these strategies on GC incidence and mortality in identifiable high-risk populations in the United States.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!