scholarly journals Salvage surgery for local recurrence after stereotactic body radiotherapy for early stage non-small cell lung cancer: a systematic review

2018 ◽  
Vol 10 ◽  
pp. 175883591878798 ◽  
Author(s):  
Chris Dickhoff ◽  
Pedro M. Rodriguez Schaap ◽  
Rene H. J. Otten ◽  
Martijn W. Heymans ◽  
David J. Heineman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Local Recurrence ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Salvage Surgery ◽  
Early Stage ◽  
Case Series ◽  
Small Cell ◽  
Small Cell Lung

Introduction: Stereotactic body (or ablative) radiotherapy (SBRT/SABR) is now a guideline-recommended treatment for medically inoperable patients with peripherally-located, stage I non-small cell lung cancer (NSCLC), and for medically operable patients who decline surgery. The 5-year local failure rate after SBRT is about 10% and in highly selected patients, surgery has been used as a salvage therapy. We performed a systematic review to address the feasibility, safety, and outcome of salvage surgery for locally recurrent early stage NSCLC after SBRT. Methods: A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase and Cochrane databases were searched and two authors independently assessed the articles. A total of seven eligible articles were identified. Results: All seven articles were retrospective case series, representing a total of 47 patients. Surgery was completed in all patients. Where reported in sufficient detail, morbidity (four studies) was between 29 and 50% (series of two patients) and 90-day mortality (six studies) was between 0% (four studies) and 11% ( n = 1, disease progression). Median ( n = 5)/mean ( n = 1) reported or calculated follow ups were 7–54.5/17.3 months. Median overall survival was reported in three studies and ranged between 13.6–82.7 months. Crude survival in three others was 2–35 months. Conclusion: Limited, low-level evidence prevents firm conclusions, but based on the existing data, salvage surgery after local recurrence of NSCLC following SBRT appears technically feasible, with acceptable morbidity and mortality in appropriately selected and counselled patients who are fit enough and who accept the risks (level of evidence 4, strength of recommendation C).

scholarly journals Updated long-term outcomes of salvage surgery after stereotactic body radiotherapy for early-stage non-small-cell lung cancer

2020 ◽  
Vol 31 (6) ◽  
pp. 892-894
Author(s):  
Keiji Yamanashi ◽  
Masatsugu Hamaji ◽  
Yukinori Matsuo ◽  
Noriko Kishi ◽  
Toyofumi Fengshi Chen-Yoshikawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stereotactic Body Radiotherapy ◽  
Salvage Surgery ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung

Abstract There is dearth of data regarding the long-term survival outcomes of salvage surgery after stereotactic body radiotherapy for early-stage non-small-cell lung cancer, as previous studies have included a short follow-up period. There is also scarce information on the management of re-relapse in previous studies. This study examined the long-term survival outcomes of patients who underwent salvage surgery for isolated local relapse (LR). We reviewed consecutive patients who underwent salvage surgery for isolated LR after stereotactic body radiotherapy for early-stage non-small-cell lung cancer between 1999 and 2015. All patients were followed up until death or at least 5 years from salvage surgery. Twelve patients were included for analysis. The median follow-up from isolated LR was 62.4 (range: 14.3–152.1) months. The 5-year overall survival rate was 58.3%, updated from 79.5% in our previous report. During the interim, new re-relapses did not occur, whereas there were 5 additional deaths. The median survival after re-relapse was 32.6 months. Our follow-up report confirmed that our patient selection for salvage surgery appeared to be appropriate and that long-term follow-up is required to assess the outcomes of patients undergoing salvage surgery. Long-term follow-up would provide detailed information on late re-relapses, treatment and outcomes of re-relapses and mortality from any causes.

scholarly journals Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Naomi E. Verstegen ◽  
Alexander P. W. M. Maat ◽  
Frank J. Lagerwaard ◽  
Marinus A. Paul ◽  
Michel I Versteegh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Salvage Surgery ◽  
Early Stage ◽  
Small Cell ◽  
Stereotactic Ablative Radiotherapy ◽  
Small Cell Lung

scholarly journals Lymphadenectomy for clinical early-stage non-small-cell lung cancer: a systematic review and meta-analysis

2016 ◽  
Vol 50 (4) ◽  
pp. 597-604 ◽  
Author(s):  
Di Meng ◽  
Zhenyu Zhou ◽  
Yiqing Wang ◽  
Luming Wang ◽  
Wang Lv ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Salvage surgery for recurrent or persistent tumour after radical (chemo)radiotherapy for locally advanced non-small cell lung cancer: a systematic review

2018 ◽  
Vol 10 ◽  
pp. 175883591880415 ◽  
Author(s):  
Chris Dickhoff ◽  
Rene H. J. Otten ◽  
Martijn W. Heymans ◽  
Max Dahele
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Treatment Option ◽  
Cell Lung Cancer ◽  
Salvage Surgery ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival

Background: Once recurrent or persistent locoregional tumour after radical chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) is identified, few curative-intent treatment options are available. Selected patients might benefit from surgical salvage. We performed a systematic review of the available literature for this emerging treatment option. Methods: A systematic literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Publications about persistent or (locoregional) recurrent disease after radical/definitive CRT for locally advanced non-small cell lung cancer were identified. Results: Eight full papers were found, representing 158 patients. All were retrospective series and data were heterogeneous: definition and indication for salvage surgery varied and the median time from radiotherapy to surgery was 4.1–33 months. Complete resection (R0) was achieved in 85–100%, with vital tumour in 61–100%. A large number of pneumonectomies were performed, and additional structures were often resected. Where reported, 90-day mortality was 0–11.4%. Reported survival metrics varied but included median overall survival 9–46 months and 5-year survival 20–75%. Conclusion: There are limited, low-level, heterogeneous data in support of salvage surgery after radical CRT. Based on this, perioperative mortality appears acceptable and long-term survival is possible in (highly) selected patients. In suitable patients (fit, no distant metastases, tumour appears completely resectable and preferably with confirmed viable tumour), this treatment option should be discussed in an experienced multidisciplinary lung cancer team.

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