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Salvage video-assisted thoracoscopic lobectomy for isolated local relapse after stereotactic body radiotherapy for early stage non-small cell lung cancer: technical aspects and perioperative management

  
@article{JOVS15368,
	author = {Masatsugu Hamaji and Toyofumi-Fengshi Chen-Yoshikawa and Yukinori Matsuo and Hideki Motoyama and Kyoko Hijiya and Toshi Menju and Akihiro Aoyam and Toshihiko Sato and Makoto Sonobe and Hiroshi Date},
	title = {Salvage video-assisted thoracoscopic lobectomy for isolated local relapse after stereotactic body radiotherapy for early stage non-small cell lung cancer: technical aspects and perioperative management},
	journal = {The Journal of Visualized Surgery},
	volume = {3},
	number = {6},
	year = {2017},
	keywords = {},
	abstract = {Limited data is available on salvage surgery for local relapse (LR) after stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC). We aimed to characterize treatment options and clarify long-term outcomes of isolated LR after SBRT for patients with clinical stage I NSCLC. Herein, we discuss technical aspects, perioperative management, and postoperative follow-up of two patients of the 12 patients undergoing salvage surgery for LR after SBRT at Kyoto University between 1999 and 2013. A 76-year-old male, 15 months after SBRT, underwent a salvage right upper lobectomy combined with adjacent right lower lobe wedge resection via video-assisted thoracoscopic surgery (VATS) for a 5.0-cm mass. Local recurrence was found 5 years after salvage surgery and treated with repeat SBRT, however he died from multiple distant metastases. An 85-year-old male, 14 months after SBRT, underwent a salvage left upper lobectomy via VATS for a 3.5-cm mass. Moderate intrapleural adhesion was noted and required careful dissection on the mediastinum. He is alive with no recurrence at 2 years from salvage surgery. Salvage VATS lobectomy was feasible after SBRT in two patients. Long-term follow-up and continued discussions at multidisciplinary conferences are required.},
	url = {http://jovs.amegroups.com/article/view/15368}
}