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Ann Thorac Surg 1999;67:340-344
© 1999 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
b Department of Cardiothoracic Anesthesiology, University of Vienna, Vienna, Austria
Accepted for publication July 18, 1998.
Address reprint requests to Dr Klepetko, Department of Cardiothoracic Surgery, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
e-mail: (walter.klepetko{at}akh-wien.ac.at)
Background. Only anecdotal reports about the results of combined resection of T4 lung tumors infiltrating the thoracic aorta exist.
Methods. Seven patients (mean age, 57.5 years; range, 43 to 78 years) underwent a resection of the infiltrated segment of the thoracic aorta together with a left pneumonectomy (n = 6) or left upper lobectomy (n = 1). Five tumors were primary non-small cell lung carcinomas (T4N2 in 3 patients, T4N1 in 2), one was a metastasis of breast cancer, and one was rhabdomyosarcoma.
Results. No patient died perioperatively. The 2 patients with rhabdomyosarcoma and metastasis of breast cancer died 2 and 7 months postoperatively. Of the 5 patients with bronchial carcinoma, 3 died after 17, 26, and 27 months as a result of distant metastasis. Two patients are alive after 14 and 50 months without evidence of disease recurrence. One-year, 2-year, and 4-year survival rates for patients with bronchial carcinoma were 100%, 75%, and 25%, respectively.
Conclusions. Combined resection of the lung and thoracic aorta can be performed with low morbidity and mortality when offered to highly selected patients. Adequate local control of tumor can be achieved for N1 and single-level N2 non-small cell lung carcinomas, but not for tumors with other histologies.
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