TY - JOUR
T1 - Vertebral body resection.
AU - Martin, Linda W.
AU - Walsh, Garrett L.
PY - 2004/5
Y1 - 2004/5
N2 - Vertebral body resection for locally advanced lung cancer can be performed with acceptable morbidity and mortality rates, and with improved long-term survival, when combined with chemotherapy and radiation. A consensus has not been reached on either the optimal extent of vertebral resection or the optimal treatment regimen. Should total vertebrectomies be the standard of care for all patients, even those with minimal spine involvement? Can the extended operative times and multiple incisions and anatomic limitations that place some of the mediastinal organs at risk be justified for potential improvement in local control, or are the quicker and potentially safer endolesional resections appropriate for these tumors? Is local control, and ultimately survival, improved when additional chemotherapy and radiation therapy is given up front, or is an uninterrupted course of a higher dose of concurrent chemotherapy and radiation therapy following surgery preferred? Ideally, these questions will be answered by means of prospective randomized trials; however, because of the small number of patients who actually present with vertebral body involvement by lung cancer, physicians may have to rely on phase 2 studies and series reports from high-volume institutions to guide their treatment algorithms in the future.
AB - Vertebral body resection for locally advanced lung cancer can be performed with acceptable morbidity and mortality rates, and with improved long-term survival, when combined with chemotherapy and radiation. A consensus has not been reached on either the optimal extent of vertebral resection or the optimal treatment regimen. Should total vertebrectomies be the standard of care for all patients, even those with minimal spine involvement? Can the extended operative times and multiple incisions and anatomic limitations that place some of the mediastinal organs at risk be justified for potential improvement in local control, or are the quicker and potentially safer endolesional resections appropriate for these tumors? Is local control, and ultimately survival, improved when additional chemotherapy and radiation therapy is given up front, or is an uninterrupted course of a higher dose of concurrent chemotherapy and radiation therapy following surgery preferred? Ideally, these questions will be answered by means of prospective randomized trials; however, because of the small number of patients who actually present with vertebral body involvement by lung cancer, physicians may have to rely on phase 2 studies and series reports from high-volume institutions to guide their treatment algorithms in the future.
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U2 - 10.1016/S1547-4127(04)00009-X
DO - 10.1016/S1547-4127(04)00009-X
M3 - Review article
C2 - 15382300
AN - SCOPUS:5144229097
SN - 1547-4127
VL - 14
SP - 241
EP - 254
JO - Thoracic surgery clinics
JF - Thoracic surgery clinics
IS - 2
ER -