%0 Journal Article
%T Surgical resection and survival of patients with unsuspected single node positive lung cancer (NSCLC) invading the descending aorta
%A Wex
%A Peter
%A Graeter
%A Thomas
%A Zaraca
%A Francesco
%A Haas
%A Victor
%J GMS Thoracic Surgical Science
%D 2009
%I 
%X Background: Surgical treatment of non-small cell lung cancer (NSCLC) with aortic invasion is still debated.Methods: Thirteen patients with locally advanced (T4) NSCLC and invasion of the descending aorta underwent pneumonectomy (n=9) or lobectomy (n=4) together with aorta en bloc resection and reconstruction (n=8) or subadventitial dissection (n=5), complete lymph node dissection, and had microscopic unsuspected node metastasis at N1 (n=5) and N2/3 (n=8) levels of whom 12 received radiation therapy. Clamp-and-sew was used to resect and reconstruct the aorta.Results: Operative mortality and morbidity rate was 0% and 23%, respectively. Four patients died of systemic tumor relapse and 2 of local recurrence. Six patients were alive after a median follow-up of 40 months (range 15¨C125 months). Overall 5-year survival rate was 45%. Median survival time and 5-year survival rate of patients after aortic resection was 35 months and 67%, respectively, and was 17 months and 0%, respectively, after aortic subadventi-tial dissection (p=0.001). N1 and N2 nodal status adversely affected survival, but survival difference was not significant (N1 versus N2/3; 52% versus 39% at 5 years; p=0.998).Conclusions: Aortic resection with single station node positive T4 lung cancer can achieve long-term survival. The data indicate that aortic resection-reconstruction is associated with better outcome than subadventitial dissection.
%K lung cancer surgery
%K aortic operation
%K off pump
%K outcomes
%U http://www.egms.de/static/de/journals/tss/2009-6/tss000016.shtml