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Vol.45 No.2 contents | Japanese/English |
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- Original Article -
Combined Resection of the Aorta in Five Primary Lung Cancer Cases
Sotarou Enatsu1, Takeshi Shiraishi1, Akinori Iwasaki1, Koushi Makimoto1, Shinichi Maekawa1, Tatsu Miyoshi1, Masafumi Hiratsuka1, Satoshi Yamamoto1, Katsunobu Kawahara2, Takayuki Shirakusa11Second Department of Surgery, Fukuoka University School of Medicine, Japan, 2Second Department of Surgery, Oita University, Japan
Object. The aim of this study was to assess clinicopathological factors in lung cancer patients undergoing combined pulmonary and aortic resection. Subjects and Methods. In all 5 patients who underwent the procedure in our hospital chest CT and MRI showed lung cancers invading the aorta. We evaluated the clinical and pathological staging according to the General Rules for Clinical and Pathological Records of Lung Cancer (6th edition, in Japanese). Results. All patients were male and habitual smokers. The mean age was 57 years old. 4 pneumonectomies and 1 lobectomy were performed. Three of the 5 patients received total replacement of the descending aorta with an artificial vessel. One patient received a patch graft for repair of the defect in the aortic arch. The remaining patient was operated upon without reconstruction. There were two complications (pneumonia and cardiac arrhythmia). Operative death did not occur in any patient. The histologic types of lung cancer were squamous cell carcinoma in 2, adenocarcinoma in 1, large cell carcinoma in 1, and small cell carcinoma in 1 patient. Pathological examination revealed pT3N0M0 (Stage IIB) in 2, pT3N2M0 (Stage IIIA) in 1, and pT4N0M0 (Stage IIIB) in 2 patients. Despite the fact that pathological examination showed tumor invasion of the aorta in 2 cases, both had good outcomes (They are alive at 3 years and 2 months, and 7 years and 2 months, respectively). Conclusion. There were discrepancies between the preoperative diagnostic images and surgical findings of lung cancer invading the aorta. Therefore patients should not be denied surgery based on unproven preoperative image or surgical findings. These surgical experiences supported the contention that combined resection of the aorta for lung cancer is worthwhile for patients undergoing complete resection and who do not have lymph node involvement.
key words: Lung cancer, Invasion to aorta, Extended resection, Prognostic factors
Received: August 9, 2004
Accepted: January 11, 2005
JJLC 45 (2): 111-114, 2005
