Surgical management of thoracic malignancies invading the heart or great vessels Journal Article
| Authors: | Park, B. J.; Bacchetta, M.; Bains, M. S.; Downey, R. J.; Flores, R.; Rusch, V. W.; Girardi, L. N. |
| Article Title: | Surgical management of thoracic malignancies invading the heart or great vessels |
| Abstract: | Background Surgical resection of thoracic malignancies involving either the heart or great vessels is uncommonly performed because of the potential morbidity and mortality for an unknown probability of significant palliation or cure. We reviewed our experience of 10 patients treated surgically, either primarily or as a component of multimodality therapy, to assess feasibility and results. Methods A retrospective review of the results in 10 patients who underwent resection of thoracic malignancies that included either great vessel or the heart was conducted. Results Histologic diagnoses included soft tissue sarcoma (n = 7), squamous cell carcinoma (n = 1), malignant thymoma (n = 1), and mediastinal teratoma (n = 1). Three patients underwent induction chemotherapy. Cardiopulmonary bypass was used in 7 patients. Structures resected included superior vena cava (n = 5), left atrium (n = 4), right atrium (n = 2), descending aorta (n = 1), and main pulmonary artery (n = 1). Concomitant anatomic pulmonary resections were performed in 3 patients. Seven patients had an R0 or R1 resection. There were no perioperative deaths. All symptomatic patients had immediate and sustained palliation of their presenting symptoms. The median length of stay was 6 days (range, 4 to 43 days). Six patients underwent postoperative systemic therapy. The overall median survival was 21.7 months (range, 3.2 to 69 months) and was 33.3 months (range, 3.7 to 69 months) for patients who had an R0 or R1 resection. Conclusions Resection of the heart and great vessels involved by thoracic malignancies can be performed with acceptable morbidity and mortality and results in significant palliation and, in some cases, prolonged survival. © 2004 by The Society of Thoracic Surgeons. |
| Keywords: | adult; cancer chemotherapy; cancer survival; clinical article; controlled study; human tissue; treatment outcome; aged; middle aged; cancer surgery; survival rate; retrospective studies; prednisone; histopathology; review; squamous cell carcinoma; carcinoma, squamous cell; cisplatin; doxorubicin; multimodality cancer therapy; gemcitabine; cancer radiotherapy; chemotherapy, adjuvant; follow up; follow-up studies; cancer palliative therapy; treatment indication; vascular neoplasms; dacarbazine; etoposide; thoracotomy; antineoplastic combined chemotherapy protocols; tomography, x-ray computed; retrospective study; ifosfamide; vinblastine; sarcoma; cancer invasion; length of stay; hospitalization; feasibility study; medical record; soft tissue sarcoma; bleomycin; malignant neoplastic disease; teratoma; neoplasm invasiveness; octreotide; mesna; thymoma; sternotomy; thorax tumor; thymus neoplasms; echocardiography, transesophageal; pulmonary artery; cardiopulmonary bypass; heart left atrium; heart metastasis; heart atria; heart neoplasms; superior cava vein; vena cava, superior; descending aorta; malignant teratoma; great blood vessel; humans; human; male; female; priority journal; heart right atrium; aorta, thoracic |
| Journal Title: | Annals of Thoracic Surgery |
| Volume: | 78 |
| Issue: | 3 |
| ISSN: | 0003-4975 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2004-09-01 |
| Start Page: | 1024 |
| End Page: | 1030 |
| Language: | English |
| DOI: | 10.1016/j.athoracsur.2004.02.043 |
| PROVIDER: | scopus |
| PUBMED: | 15337042 |
| DOI/URL: | |
| Notes: | Ann. Thorac. Surg. -- Cited By (since 1996):25 -- Export Date: 16 June 2014 -- CODEN: ATHSA -- Source: Scopus |
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