Total or partial vertebrectomy for lung cancer invading the spine

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Spinal Oncology

Background:

• Lung cancer invading the spine presents significant surgical challenges with high morbidity and mortality.
• Advancements in surgical techniques and perioperative care may improve outcomes for these complex cases.
• This study details a surgical approach and evaluates outcomes for lung cancer with spinal invasion.

Purpose of the Study:

• To describe the surgical approach for lung cancer invading the spine.
• To assess the outcomes, including morbidity, mortality, survival, and recurrence rates, of lung cancer surgery combined with vertebrectomy.

Main Methods:

• Retrospective review of eight patients with lung cancer and vertebral invasion treated between January 2011 and April 2015.
• Surgical procedures included total vertebrectomy, hemi vertebrectomy, and transverse-process resection.
• Preoperative evaluation involved chest CT, MRI, and PET-CT; some patients received neoadjuvant therapy.

Main Results:

• Complete resection was achieved in all eight patients undergoing total or partial vertebrectomy.
• Morbidity occurred in 75% of patients, with no mortality.
• Survival rates were encouraging: 75% survived post-surgery, with a 71.4% five-year overall survival rate and 50% recurrence-free survival at follow-up.

Conclusions:

• Lung cancer surgery combined with vertebrectomy is an aggressive procedure associated with high morbidity.
• Despite the challenges, this approach is a viable and promising treatment option for carefully selected patients, particularly those with N0M0 disease.
• The study highlights the potential for improved outcomes in lung cancer with spinal invasion through specialized surgical intervention.