En bloc resection of XXXX invading the spine.

@entity1 @entity1149 @entity1753
OBJECTIVE: To describe our surgical en bloc approach and to assess the outcome and survival of @entity1149 ( @entity1149 ) invading the spine. METHODS: We retrospectively reviewed our prospective database of all @entity1 , who underwent lung resection with en bloc hemivertebrectomy or total vertebrectomy for @entity1149 between January 2003 and December 2008 in an individualized multimodality treatment concept. Survival was estimated by the Kaplan-Meier method. Log-rank analyses were used to compare groups. RESULTS: Twenty-eight @entity1 (age 58.9    12.9 years) were diagnosed with @entity1149 invading the spine at a single center. Eight of those @entity1 were inoperable. Twenty @entity1 proceeded to surgery with en bloc hemivertebrectomy (n = 16) or total vertebrectomy (n = 4). Six @entity1 had induction chemotherapy (30%). Complete resection could be achieved in 16 @entity1 (80%). Morbidity was observed in eight @entity1 (40%); no mortality occurred. Adjuvant radiation (n = 14) or chemoradiation (n = 6) was administered with 66 Gy. The mean survival and 5-year survival for @entity1 , who underwent surgery (n=20), were 46.0 months and 47%, respectively. Inoperable @entity1 had poorer survival (14.0 months; p = 0.004). Sublobar resections (p = 0.002) and incomplete resections (p = 0.02) were associated with inferior survival. @entity1753 (p = 0.088), hemivertebrectomy (p = 0.062), and age < 70 years (p = 0.076) trended toward prolonged survival. CONCLUSIONS: Multimodality treatment including en bloc lung resections with hemivertebrectomy or total vertebrectomy offer promising long-term survival in highly selected @entity1 with @entity1149 invading the spine. These extended resections can be performed with acceptable morbidity and mortality in specialized centers. @entity1 aged >=  70 years should be selected very carefully for radical resection. Sublobar resections should be avoided.
