Extended lung resection of the left atrium and the large vessels aorta (vena cava superior and intrapericardial pulmonary artery)

作者：Kaifi J T^*; Passlick B

来源：Onkologe, 2014, 20(10): 982-+.

DOI：10.1007/s00761-014-2734-y

• Locally advanced lung cancer
• Neoadjuvant therapy
• Multimodal treatment
• Extended lung resection
• Vascular invasion

Background. Locally advanced lung cancers are tumors that either infiltrate neighboring structures or present with an extensive mediastinal lymphadenopathy. In contrast to N2 mediastinal disease which has a poor prognosis, locally infiltrative T4 tumors with invasion of the left atrium or the major vessels are a technical challenge and surgery is potentially curative.
Objectives. This article outlines the rare indications for extended resection of locally advanced T4 lung cancer with infiltration of the atrium, aorta, vena cava superior and intra-pericardial pulmonary artery.
Material and methods. The evidence for extended lung resection was gathered by a literature review using the databases Medline and PubMed.
Results. A multidisciplinary therapeutic concept should be established whenever an extended lung resection is considered. In general neoadjuvant chemotherapy should be performed as it targets micrometastatic disease, can identify a rapid tumor progression despite treatment, and potentially increase rates of complete resection. In this review article we focus on the rare indications for surgery on locally advanced T4 lung cancer with invasion of the left atrium, aorta, superior vena cava and intra-pericardial pulmonary artery.
Discussion. Extended resection for locally advanced lung cancer with infiltration of the atrium and intra-pericardial pulmonary artery can be considered in carefully selected patients; however, the indications should be strictly established with great caution for involvement of the superior vena cava and aorta.

• 出版日期2014-10