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Open Access 01-12-2016 | Research

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

Authors: Naomi E. Verstegen, Alexander P. W. M. Maat, Frank J. Lagerwaard, Marinus A. Paul, Michel I Versteegh, Joris J. Joosten, Willem Lastdrager, Egbert F. Smit, Ben J. Slotman, Joost J. M. E. Nuyttens, Suresh Senan

Published in: Radiation Oncology | Issue 1/2016

Abstract

Introduction

The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC).

Methods

Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases. Complications were scored using the Dindo-Clavien-classification.

Results

Nine patients who underwent surgery for a local recurrence were identified. Median time to local recurrence was 22 months. Recurrences were diagnosed with CT- and/or 18FDG-PET-imaging, with four patients also having a pre-surgical pathological diagnosis. Extensive adhesions were observed during two resections, requiring conversion from a thoracoscopic procedure to thoracotomy during one of these procedures. Three patients experienced complications post-surgery; grade 2 (N = 2) and grade 3a (N = 1), respectively. All resection specimens showed viable tumor cells. Median length of hospital stay was 8 days (range 5–15 days) and 30-day mortality was 0 %. Lymph node dissection revealed mediastinal metastases in 3 patients, all of whom received adjuvant therapy.

Conclusions

Our experience with nine surgical procedures for local recurrences post-SABR revealed two grade IIIa complications, and a 30-day mortality of 0 %, suggesting that salvage surgery can be safely performed after SABR.

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Title: Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer
Authors: Naomi E. Verstegen
Alexander P. W. M. Maat
Frank J. Lagerwaard
Marinus A. Paul
Michel I Versteegh
Joris J. Joosten
Willem Lastdrager
Egbert F. Smit
Ben J. Slotman
Joost J. M. E. Nuyttens
Suresh Senan
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2016
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-016-0706-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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