Objective: We studied possible indications and combined resection in patients with lung cancer and mediastinal tumors requiring combined thoracic aortic or upper digestive tract resection.Methods: Ten patients with lung cancer and malignant mediastinal tumors (9 men and 1 woman aged 39 to 72 years; mean: 60.5) underwent combined aortic or upper digestive tract resection.Results: Fiv — 3 with primary lung cancer, 1 with thymic cancer, and 1 with liposarcoma —, underwent combined aortic resection. In 2 each, lung cancer and malignant mediastinal tumor had infiltrated the thoracic aorta. The remaining case of lung cancer was complicated by aortic aneurysm in the distal arch. Cardiopulmonary bypass was conducted in 4, and selective cerebral perfusion in 2. Three patients are alive after 11, 22, and 61 months without disease recurrence. Those undergoing combined upper digestive tract resection all had lung cancer, with 4 having tumors infiltrating the esophagus or corpus ventriculi. The remaining patient had both lung and esophageal cancer. The patient treated with combined corpus ventriculi resection has survived 24 months and the patient treated with combined esophageal resection has survived 12 months without disease recurrence. The 1-year survival rate was 60%, 2-year 23%, and 3-year 23%. Prognosis was generally poor with the longest survival 13 months with N2 lung cancer.Conclusions: In combined resection due to malignant mediastinal tumor, T4N0-1 lung cancer, or diseases such as aortic aneurysm, prognosis can be expected to improve. Despite the often poor prognosis in T4N2 lung cancer, surgical intervention may be indicated to avoid complications due to tumor invasion and to lengthen survival and improve quality of life.
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Nakahara K, Ohno K, Matsumura A, Hirose H, Matsuda H, Nakano S, et al. Extended operation for lung cancer invading the aortic arch and superior vena cava. J Thorac Cardiovasc Surg 1989; 97: 428–33.
Tokuda H, Waku M, Mori J, Koyama A, Anno H, Hata E. Combined resection of the aorta for lung cancer invading the descending aorta (Eng abstr). J Jpn Assn Thorac Surg 1988; 36: 947–54.
Saito Y, Yamakawa Y, Niwa H, Kiriyama M, Fukai I, Fujii Y. Surgical treatment for lung cancer invading thoracic aorta. J Jpn Assn Thorac Surg 1998; 46: 318–24.
Tsuchiya R, Asamura H, Kondo H, Goya T, Naruke T. Extended resection of the left atrium, great vessels, or both for lung cancer. Ann Thorac Surg 1994; 57: 960–5.
Rusch VW, Albain KS, Crowley JJ, Rice TW, Lonchyna V, McKenna R Jr, et al. Surgical resection of stage IIIA and IIIB non-small cell lung cancer after concurrent induction chemoradiotherapy. J Thorac Cardiovasc Surg 1993; 105: 97–106.
Macchiarini P, Chapelier AR, Monnet I, Vannetzel JM, Rebischung JL, Cerrina J, et al. Extended operations after induction therapy for stage IIIB (T4) nonsmall-cell lung cancer. Ann Thorac Surg 1994; 57: 966–73.
Matsumoto I, Shimizu J, Oda M, Murakami S, Uno Y, Yasetsu K, et al. Combined resection of the aortic wall in T4 lung cancer under the assistant devices. Jpn J Thorac Surg 1993; 46: 1034–8.
Schrump DS. Cardiopulmonary bypass for extended resection of thoracic malignancies: Franco KL, Putnum JB, ed. Advanced therapy in thoracic surgery. London: B.C. Decker Inc., 1998: 238–43.
Tanaka K, Murota Y, Andoh T, Asano K. A case of nonsmall-cell primary lung cancer invading distal aortic arch and left subclavian artery (Eng abstr). J Jpn Assn Thorac Surg 1995; 43: 1854–7.
Matsubara T, Ueda M, Takahashi T, Nakajima T, Nishi M. Surgical treatment of cancer of thoracic esophagus in association with major pulmonary operation. J Am Coll Surg 1997; 185: 520–4.
Read at the Fifty-first Annual Meeting of the Japanese Association for Thoracic Surgery, Symposium Tokyo, October 2–4, 1998.
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Oyama, K., Onuki, T., Mae, M. et al. Combined thoracic aortic or upper digestive tract resection for lung cancer and malignant mediastinal tumor. Jpn J Thorac Caridovasc Surg 48, 9–15 (2000). https://doi.org/10.1007/BF03218079
- lung cancer
- malignant mediastinal tumor
- aortic resection
- upper digestive tract resection
- cardiopulmonary bypass