P-129
SLEEVE LOBECTOMY VERSUS PNEUMONECTOMY AFTER INDUCTION THERAPY: SHORT AND LONG-TERM RESULTS OF A MULTICENTRIC STUDY Free

Although sleeve lobectomy (SL) is considered the best therapeutic option in locally advanced non-small cell lung cancer (LA-NSCLC) patients even when pneumonectomy (PN) is tolerated, its feasibility and long-term results after induction therapy (IT) are very rarely investigated. We present the results of a multicentre experience.

From January 1990 to December 2012, patients from 3 tertiary referral centres underwent SL (bronchial, arterial or both) or PN for LA-NSCLC after IT (chemotherapy alone or concurrent radio-chemotherapy). The indication to SL was done whenever technically possible. Clinical and pathological variables were collected and perioperative results were assessed and compared in both groups. Long-term survival was investigated according to clinical and pathological features and calculated by the Kaplan-Meier method and log-rank test as well as by the Cox proportional hazard regression model.

There were 119 patients, 94 male/female = 94/25. PN was performed in 68 patients and SL in 51 patients. Overall 30-day mortality and morbidity were 2.9% and 22.1% for PN vs 3.9% and 9.8% for SL, respectively. One-year, 3-year and 5-year survival rates were: 82.4%, 50.9%, 43.1% in PN vs 92.5%, 60.5%, 53.8% in SL, respectively. Overall recurrence rate was 32/66 (47.0%) in PN and 21/49 (42.8%) in SL (P = 0.34) and among these, 8/66 local recurrences in PN (12.1%) vs 11/49 in SL (22.4%) (P = ns). The Cox analysis suggested N-status and right side as independent mortality risk factors (HR = 1.96 [CI 95%: 1.12-3.44], P = 0.018 and HR = 2.96 [CI 95%: 1.13-8.66], P = 0.047, respectively) in SL-group. Also, N status and right side were powerful risk factors of relapse (HR = 2.33 [CI 95%: 1.17-4.64], P = 0.016 and HR = 2.96 [CI 95%: 1.13-8.66], P = 0.046 respectively), in patients who had undergone SL.

For LA-NSCLC, a SL represents a safe and effective surgical option when compared to PN even after IT, with comparable early and long-term results.

All authors have declared no conflicts of interest.