Vol. 20 JA2016 - thoracic

T-10 – Very long-term survival following lung surgery for cancer in high-risk patients after perioperative pulmonary rehabilitation

novembre 29, 2016
Auteur correspondant : Patrick Bagan

Patrick Bagan, Viorel Oltean, Florent Couineau, Christine Raynaud, Rym Zaimi, Bassel Dakhil

Institution : Service de chirurgie thoracique et vasculaire, CH Victor-Dupouy, Argenteuil

Objectives : The benefits of a rehabilitation program before lung carcinologic resection on long term survival remain to define. The purpose of this observational study was to assess the effects of the rehabilitation on long term outcomes in patients who were at a high operative risk,which immediate outcome were previously reported (Rev Mal Respir. 2013;30[5]:414-9).

Methods : Between January 2010 and december 2011, a cohort of 20 consecutive patients, with a clinical N0 non small cell lung cancer considered as non-operable were included. The protocol included a clinical examination and a Chest CT Scan every six months during two years and every twelve months the following years. Survival was calculated with the Kaplan-Meier method.

Results : In this population, they were 16 men and 4 women with mean age of 66 years [44-79] Surgical resection was performed in all patients (lobectomy, n=15; pneumonectomy, n=3; bilobectomy, n=2). The morbidity rate was 20%, the mortality rate was 5%. Three pN+ patients received adjuvant chemotherapy. During follow-up, 6 patients died (cancer recurrence, n=5; respiratory failure, n=1). The kaplan meier five year survival rate was 70 %.

Conclusion : Peri operative Pulmonary rehabilitation allows carcinologic surgery performance and a good long-term survival at first-line not eligible patients.