Salvage pulmonary resection after stereotactic body radiotherapy: A feasible and safe option for local failure in selected patients

The Journal of Thoracic and Cardiovascular Surgery
Mara B AntonoffDavid C Rice

Abstract

For inoperable patients with pulmonary malignancy, stereotactic body radiotherapy is a reasonable therapeutic option. Despite good early tumor control, local failure occurs in up to 10% of patients by 3 years. Because management of local recurrence after stereotactic body radiotherapy is unclear, we evaluated use of surgery as a salvage option. A retrospective review was conducted of consecutive patients from a single institution who underwent salvage resection of primary and metastatic pulmonary malignancies previously treated with stereotactic body radiotherapy. In addition, a literature search was conducted to identify previous reports of pulmonary resection for local stereotactic body radiotherapy failures, to allow cumulative analyses with previously published cases. A total of 21 patients met inclusion criteria. The median time between stereotactic body radiotherapy and salvage surgery was 16.2 months (range, 6.4-71.5). Postoperative complications occurred in 7 patients (18.9%), in whom atrial arrhythmias and prolonged air leaks (>5 days) were most frequent (n = 2 each, 5.4%). There was no local recurrence after salvage surgery. Distant failure occurred in 5 of 21 patients (23.8%) at a median of 36.2 months, and median di...Continue Reading

Citations

Jan 17, 2019·Interactive Cardiovascular and Thoracic Surgery·Yoichi OhtakiKen Shirabe
Dec 27, 2019·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Kyle G MitchellMara B Antonoff
Sep 26, 2020·Interactive Cardiovascular and Thoracic Surgery·Keiji YamanashiHiroshi Date
Apr 12, 2019·Frontiers in Oncology·Katsuyuki ShiraiTakashi Nakano
Jan 9, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Walter WederGaetano Rocco
Nov 13, 2019·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Eric D BrooksUNKNOWN International Association for the Study of Lung Cancer Advanced Radiation Technology Committee
Apr 26, 2020·The Journal of Thoracic and Cardiovascular Surgery·Kyle G MitchellUNKNOWN MD Anderson Cancer Center Oligometastatic Lung Cancer Working Group
Apr 27, 2021·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Neal AndruskaUNKNOWN Advanced Radiation Therapy Committee for the International Association for the Study of Lung Cancer
Nov 30, 2020·The Annals of Thoracic Surgery·Kimihiro ShimizuUNKNOWN Japanese Association for Chest Surgery

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