Simultaneous operations in thoraco-abdominal clinical oncology

Abstract

Objective: To increase radical operability of cases with synchronous multiple primary malignant tumours (SMPTM) of the thorax and abdomen, and of cancer patients with concomitant severe heart disease simultaneous operations are implemented in the clinical practice.

Methods: Twenty-seven simultaneous operations for SMPMT (17) and for cancers of different sites and concomitant cardiac disease (10) were performed at the Surgical Department of Thoraco-Abdominal Oncology, N.N. Blokhin Memorial Cancer Research Centre. All SMPMT cases had lung cancer. The second tumours were gastric cancer (6), oesophageal cancer (7), laryngeal cancer (3) and opposite lung cancer (1). Coronary artery bypass grafting for ischaemic heart disease was made in nine cases simultaneously with lung resection (4), tracheal resection (1), resection of the stomach or gastrectomy (4). Mitral valve commissurotomy and left pneumonectomy for lung cancer was made in one case.

Results: Two patients died from therapeutic complications early postoperatively. Median survival after simultaneous operations for SMPMT was 26 months. One patient undergoing simultaneous operation for cardiac disease and lung cancer died from cancer progression at 1 year following surgery. The remaining patients were followed up for 2 years free from evidence of cancer or heart disease.

Conclusion: Simultaneous operations increase resectability, radicality and functional operability and therefore promise improvement of follow-up results in the most serious category of cancer patients in question.