Koyi, Hirsh

Wedin, Rikard

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P3-234: Survival in lung cancer patients with pathologic fracture 

Journal of Thoracic Oncology • Volume 2, Number 8, Supplement 4, August 2007  12th World Conference on Lung Cancer
Copyright © 2007 by the International Association for the Study of Lung CancerS780
P3-234 NSCLC: Surgery Posters, Wed, Sept 5 – Thur, Sept 6 
Survival in lung cancer patients with pathologic fracture
Koyi, Hirsh1 Wedin, Rikard2 
1 Karolinska University Hospital, Solna, Stockholm, Sweden 2 Dept 
of Orthopaedics, Karolinska University Hospital-Solna, Stockholm, 
Sweden 
Background: About 30-40% of all lung cancer patients will develop 
bone metastases during the course of their disease and skeletal related 
events like pain, pathologic fractures and paraparesis are common. 
These complications often occur during the last months of life; how-
ever, some patients will live for years. The aim of the study was to 
identify factors associated with survival. 
Material and Methods: This retrospective study was based on a 
consecutive series of 100 patients with lung cancer treated surgi-
cally for metastatic lesions of long bones or due to vertebral fracture 
and paraparesis from 1986 through 2006. There were 45 men and 55 
women with a median age of 60 and 63 years respectively. 68 patients 
were surgically treated for a long bone fracture and 32 patients due 
to paraparesis. Of the patients operated for a long bone fracture, 73 
had a complete fracture whereas 33 were treated for an impending 
fracture. Adenocarcinoma was diagnosed in 60 patients, squamous cell 
carcinoma in 15, low differentiated non-small cell cancer in 11, SCLC 
in large cell carcinoma in 8, bronchoalveolar carcinoma 1 and large 
cell carcinoma in 5. 89% of male patients and 86% of the females were 
smokers or former smokers. 
Results: The Kaplan-Meier survival rate for the series of 100 patients 
was 0.19 at 1 year after surgery, 0.07 at 2 years and 0.04 after 3 years. 
The median survival was 319 days for patients with adenocarcinoma, 
253 days for patients with SCLC and 244 days for squamous cell carci-
noma (p<0.014). 33% of the patients had skeletal metastasis as the ﬁrst 
sign of disease. Their survival was signiﬁcantly shorter than patients 
with bone metastasis diagnosed as a secondary event, 94 vs 319 days 
(P<0.049). Patients treated for a long bone fracture had a signiﬁcantly 
longer survival than patients operated due to paraparesis 316 vs 207 
days (p<0.038). There was a tendency to shorter survival in patients 
with complete as opposed to impending fractures (p<0.07). 
Conclusion: The one year survival rate 0.19 implicates that palliative 
surgery is justiﬁed in patients with skeletal metastasis of lung cancer. 
However, patients with skeletal metastasis as the ﬁrst sign of disease 
and patients surgically treated for paraparesis were associated with 
poor prognosis. 
P3-235 NSCLC: Surgery Posters, Wed, Sept 5 – Thur, Sept 6 
The clinical experiences of double sleeve lobectomy of the bronchus 
and the pulmonary artery
Kuang, Yukang; Zeng, Laiduo; Wu, Jiufa 
Department of Thoracic Surgery, JiangXi Tumor Hospital, Nanchang, 
China
Objective: Investigate the methods and the results of double sleeve lo-
bectomy of the bronchus and the pulmonary artery in surgical treatment 
for the central lung cancer.
Methods: From March 1995 to March 2006, double sleeve resection 
and reconstruction of bronchus and pulmonary artery was performed in 
12 cases with central lung cancer. Among them, double sleeve left up-
per lobectomy in 10 cases, double sleeve right upper-middle lobectomy 
in 2 cases.
Results: Occurring irregular heartbeat after operation in 2 cases, the 
obstruction pneumonia and pulmonary atelectasis in 1 case. The squa-
mous cell carcinoma in 9 cases, adenocarcinoma in 2 cases, SCLC in 1 
case. No surgical operation death. The 1,3 and 5 year survival rate was 
81.9% (9/11), 100%(7/7) and 100%(5/5) respectively. 
Conclusion: The double sleeve lobectomy of bronchus and pulmonary 
artery maximally reserving the healthy lung and maximally cutting off 
the tumor at the same time, avoiding pneumonectomy. The postopera-
tive living quality of patients is well.
P3-236 NSCLC: Surgery Posters, Wed, Sept 5 – Thur, Sept 6 
Tumor size and 5-year survival rate in surgically treated patients 
with pN0M0 NSCLC
Kupis, Wlodzimierz R.1 Rudzinski, Piotr M.1 Orlowski, Tadeusz M.2 
1 National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland 
2 National Institute of Tuberculosis and Lung Cancer, Warsaw, Poland 
Background: In present TNM system the border line between T1 and 
T2 is 3cm of diameter in tumor size. We tried to estimate the inﬂuence 
of tumor size on the 5-year survival rate in MSCLC patients operated 
on with pN0M0.
Method: We have analyzed retrospectively the group of 328 patients 
with pN0 NSCLC operated on in our institution between year 1998 and 
2000. The time of follow-up was 5 to 8 years.
We divided our pts into 7 groups considering the tumor size criteria 
(<1cm, 1-2cm, 2-3cm, 3-5cm, 5-7cm, 7- 0cm, > 10cm).
Results: The histology of resected tumors was adenocarcinoma in 108 
(38%), squamous in 154 (47%), NSCLC in 10 (3.1%), large cell In 9 
(2.7%), carcinoid in 22 (6.7%), other in 8 (2.4%). The type of resection 
included pneumonectomy in 56 pts, lobectomy in 263 pts and wedge 
resection/segmentectomy in 8 pts.
The number of pts incorporated in tumor size group was 10, 50 76, 
100, 47 26 and 9 pts in 1cm group, 1-2cm group, 2-3cm group, 3-5cm 
group, 5-7cm group, 7-10cm and > 10cm group respectively. The 5-
year survival rates were 80%, 78%, 79%, 57%, 59%, 44% and 33.3% 
respectively.
Conclusions: We have found no statistically signiﬁcant deference 
between ﬁrst three groups of patients. Therefore we concluded that the 
5cm border line in tumor size might be prognostic in terms of 5-year 
survival rate in NSCLC patients undergoing radical resection of lung 
tissue.


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P3-234: Survival in lung cancer patients with pathologic fracture

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