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MMCTS (October 9, 2006). doi:10.1510/mmcts.2005.001511
Copyright © 2006 European Association for Cardio-thoracic Surgery

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Lorenzo Spaggiari
Francesco Petrella
Francesco Leo
Alessandro Borri
Domenico Galetta
Roberto Gasparri
Paolo Scanagatta
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Procedure


Superior vena cava resection for lung and mediastinal malignancies

Lorenzo Spaggiaria,b,*, Francesco Petrellab, Francesco Leob, Giulia Veronesib, Piergiorgio Sollib, Alessandro Borrib, Domenico Galettab, Roberto Gasparrib and Paolo Scanagattab

a University of Milan School of Medicine, Milan, Italy
b European Institute of Oncology, Division of Thoracic Surgery, Via Ripamonti 435, 20141 Milan, Italy

* Corresponding author: * Tel.: +39-02-5748 9666; fax: +39-02-57489698. E-mail: lorenzo.spaggiari{at}ieo.it

Even though the benefit of superior vena cava resection for lung and mediastinal malignancies remains controversial, the recent international experiences have demonstrated technical feasibility of such an extended surgery with acceptable postoperative morbidity and mortality. Concerning lung cancer, a multicentric international study over a 40-year period reports a risk of developing postoperative complications and mortality of 30% and 12%, respectively, with a 5-year probability of survival of 21%. The same study, analysing the results of the last 10 years, demonstrated an improvement of the outcome with a 6% of postoperative mortality, with a 5-year probability of survival of 28%. With regards to mediastinal malignancies, completeness of surgical resection is still considered one of the most important prognostic factors, and extended SVC resection could improve local control and disease free survival. In conclusion, radical resection of lung cancer and mediastinal malignancies involving SVC, is feasible, and it could lead to permanent cure in carefully selected patients.

Key Words: Extended resection • Lung cancer • Mediastinal tumour • Superior vena cava • Surgery


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Superior Vena Cava Resection for Lung and Mediastinal Malignancies: A Single-Center Experience With 70 Cases
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Ann. Thorac. Surg. 2007 83: 223-230. [Abstract] [Full Text] [PDF]

Long-term graft patency after replacement of the brachiocephalic veins combined with resection of mediastinal tumors
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J. Thorac. Cardiovasc. Surg. 2005 129: 809-812. [Abstract] [Full Text] [PDF]

Surgical management of thoracic malignancies invading the heart or great vessels
Bernard J. Park, Matthew Bacchetta, Manjit S. Bains, Robert J. Downey, Raja Flores, Valerie W. Rusch, and Leonard N. Girardi
Ann. Thorac. Surg. 2004 78: 1024-1030. [Abstract] [Full Text] [PDF]





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