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Surgical Staging and Advanced Surgical Techniques in Early Stage Non-small Cell Lung Cancers

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Principles and Practice of Radiotherapy Techniques in Thoracic Malignancies

Abstract

A 70-year-old female patient, who did not have any symptoms, was admitted to the hospital for routine health checkup. She had no significant past medical history other than a 40 pack-year history of smoking. Systematic physical examination was normal. Chest X-ray revealed a suspected opacity in the left upper zone. Thoracic computerized tomography showed peripheral solitary pulmonary nodule in the left lung upper lobe. FDG PET/CT demonstrated high FDG uptake in the left upper lobe nodule with maximal standard uptake value (SUVmax) 7,4 (Fig. 11.1). There was no FDG uptake in the other systems. Cranial MRI did not reveal any metastatic lesion. The patient was clinically staged as cT1aN0M0. Minimally invasive surgery was recommended to patient for diagnosis and treatment.

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References

  1. Falcoz PE, Puyraveau M, Thomas PA, Decaluwe H, Hürtgen M, Petersen RH, Hansen H, Brunelli A, ESTS Database Committee and ESTS Minimally Invasive Interest Group. Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database. Eur J Cardiothorac Surg. 2016;49:602–9.

    Google Scholar 

  2. Boffa DJ, Allen MS, Grab JD, et al. Data from the Society of Thoracic Surgeons General Thoracic Surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg. 2008;135:247–54.

    Article  PubMed  Google Scholar 

  3. Kirby TJ, Mack MJ, Landreneau RJ, Rice TW. Lobectomy. Video-assisted thoracic surgery versus muscle-sparing thoracotomy. A randomized trial. J Thorac Cardiovasc Surg. 1995;109:997–1001.

    Article  CAS  PubMed  Google Scholar 

  4. Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg. 2000;24:27–30.

    Article  CAS  PubMed  Google Scholar 

  5. Yim AP, Wan S, Lee TW, et al. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg. 2000;70:243–7.

    Article  CAS  PubMed  Google Scholar 

  6. Erus S, Tanju S, Kapdagli M, Ozkan B, Dilege S, Toker A. The comparison of complication, pain, quality of life, and performance after lung resections with thoracoscopy and axillary thoracotomy. Eur J Cardiothorac Surg. 2014;46:619–09.

    Article  Google Scholar 

  7. Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA. Surgery for early stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg. 2008;86:2008–16.

    Article  PubMed  Google Scholar 

  8. Muraoka M, Oka T, Akamine S, et al. Video-assisted thoracic surgery lobectomy reduces the morbidity after surgery for stage I non-small cell lung cancer. Jpn J Thorac Cardiovasc Surg. 2006;54:49–55.

    Article  PubMed  Google Scholar 

  9. Park JS, Kim K, Choi MS, et al. Video-assisted thoracic surgery lobectomy for pathologic stage non-small cell lung cancer: a comparative study with thoracotomy lobectomy. Kor J Thorac Cardiovasc Surg. 2011;44:32–8.

    Article  Google Scholar 

  10. Flores RM, Park BJ, Dycoco J, et al. Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. J Thorac Cardiovasc Surg. 2009;138:11–8.

    Article  PubMed  Google Scholar 

  11. Cajipe MD, Chu D, Bakaeen FG, Casal RF, LeMarie SA, Coselli JS, Cornwell LD. Video-assisted thoracoscopic lobectomy is associated with better perioperative outcomes than open lobectomy in a veteran population. Am J Surg. 2012;204:607–12.

    Article  PubMed  Google Scholar 

  12. Stephens N, Rice D, Correa A, Hofstetter W, Mehran R, Roth J, Walsh G, Vaporciyan A, Swisher S. Thoracoscopic lobectomy is associated with improved short-term and equivalent oncological outcomes compared with open lobectomy for clinical stage I non-small-cell lung cancer: a propensity match analysis of 963 cases. Eur J Cardiothorac Surg. 2014;46:607–13.

    Article  PubMed  Google Scholar 

  13. Paul S, Altorki NK, Sheng S, Lee PC, Harpole DH, Onaitis MW, Stiles BM, Port JL, D’Amico TA. Thoracoscopic lobectomy associated with lower morbidity than open lobectomy: a propensity matched analysis from the STS database. J Thorac Cardiovasc Surg. 2010;139:366–78.

    Article  PubMed  Google Scholar 

  14. Farjah F, Wood DE, Mulligan MS, Krishnadasan B, Heagerty PJ, Symons RG, et al. Safety and efficacy of video-assisted versus conventional lung resection for lung cancer. J Thorac Cardiovasc Surg. 2009;137:1415–21.

    Article  PubMed  Google Scholar 

  15. Scott WJ, Allen MS, Darling G, Meyers B, Decker PA, Putnam JB et al. Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg. 2010;139:976–81; discussion 981–3.

    Google Scholar 

  16. Melfi FMA, Menconi GF, Mariani AM, Angeletti CA. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg. 2002;21:864–8.

    Article  PubMed  Google Scholar 

  17. Meyer M, Gharagozloo F, Tempesta P, Margolis M, Strother E, Christenson D. The learning curve of robotic lobectomy. Int J Med Robot. 2012;8:448–52.

    Article  PubMed  Google Scholar 

  18. Dylewski MR, Ohaeto AC, ARNP, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Surg. 2011;23:36–42.

    Google Scholar 

  19. Nasir BS, Bryant AS, Minnich DJ, Wei B, Cerfolio RJ. Performing robotic obectomy and segmentectomy: cost, profitability and outcomes. Ann Thorac Surg. 2014;98:203–9.

    Article  PubMed  Google Scholar 

  20. Park BJ, Melfi F, Mussi A, Maisonneuve P, Spaggiari L, Da Silva RKC, Veronesi G. Robotic lobectomy for non-small cell lung cancer (NSCLC). Long-term oncologic results. J Thorac Cardiovasc Surg. 2012;143:383–9.

    Article  PubMed  Google Scholar 

  21. Toker A, Ozyurtkan MO, Kaba E, Ayalp K, Demirhan O, Uyumaz E. Robotic anatomic lung resections: the initial experience and description of learning in 102 cases. Surg Endosc. 2016;30:676–83.

    Google Scholar 

  22. Veronesi G, Galetta D, Maisonneuve P, Melfi F, Schmid RA, Borri A, Vannucci F, Spaggiari L. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg. 2010;140:19–25.

    Article  PubMed  Google Scholar 

  23. Cerfolio RJ, Byrant AS, Skylizard L, Minnich DJ. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg. 2011;142:740–6.

    Article  PubMed  Google Scholar 

  24. Lee BE, Korst RJ, Kletsman E, Rutledge JR. Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: are there outcomes advantages? J Thorac Surg. 2014;147:724–9.

    Article  Google Scholar 

  25. Rami-Porta R. Supermediastinoscopies: a step forward in lung cancer staging. J Thorac Oncol. 2007;4:355–6.

    Article  Google Scholar 

  26. Hürtgen M, Friedel G, Toomes H, Fritz P. Radical video-assisted mediastinoscopic lymphadenectomy (VAMLA)-technique and first results. Eur J Cardiothorac Surg. 2002;21:348–51.

    Article  PubMed  Google Scholar 

  27. Kim HJ, Kim YH, Choi SH, Kim HR, Kim DK, Park SI. Video-assisted mediastinoscopic lymphadenectomy combined with minimally invasive pulmonary resection for left-sided lung cancer: feasibility and clinical impacts on surgical outcomes. Eur J Cardiothorac Surg. 2016;49:308–13.

    Google Scholar 

  28. Darling GE, Allen MS, Decker PA, Ballman K, Malthaner RA, Inculet RI, Jones DR, McKenna RJ, Landreneau RJ, Putnam Jr JB. Number of lymph nodes harvested from a mediastinal lymphadenectomy: results of the randomized, prospective American College of Surgeons Oncology Group Z0030 trial. Chest. 2011;139:1124–9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. NCCN Clinical Practice Guidelines in Oncology. Non-small cell lung cancer (v.2.2013). 2013. http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed 2 July 2013.

  30. Rami-Porta R, Wittekind C, Goldstraw P. International Association for the Study of Lung Cancer (IASLC) Staging Committee: complete resection in lung cancer surgery: proposed definition. Lung Cancer. 2005;49:25–33.

    Article  PubMed  Google Scholar 

  31. Yue D, Gong L, You J, Su Y, Zhang Z, Zhang Z, Gu F, Wang M, Wang C. Survival analysis of patients with non-small cell lung cancer who underwent surgical resection following 4 lung cancer resection guidelines. BMC Cancer. 2014;14:422.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Sukru Dilege MD .

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Dilege, S., Tanju, S., Erus, S. (2016). Surgical Staging and Advanced Surgical Techniques in Early Stage Non-small Cell Lung Cancers. In: Ozyigit, G., Selek, U., Topkan, E. (eds) Principles and Practice of Radiotherapy Techniques in Thoracic Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-319-28761-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-28761-4_11

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