Salvage Surgery in Persistent Lung Cancer

<bold>Objective:</bold> The term “salvage surgery” has been defined as surgical resection of persistent or recurrent tumors after previous local treatments with curative intent or exclusive chemo-radiotherapy in the case of bulky tumors originally considered ineligible for surgery. It should therefore be considered a last attempt to offer the patient a curative treatment for their disease. We present our series of salvage surgery. <bold>Methods:</bold> Among almost 1000 thoracic procedures , 53 patients (5.3%) underwent salvage operations due to locally persistent advanced disease after chemotherapy or/and immunotherapy or in cases of lung cancer mimicking huge abscesses, where induction therapy would be unsuitable. There were 42 men and 11 women ranging in age from 56 to 78 years. <bold>Results:</bold> After a thorough examination and MDT consultation including an informed consent, the patients were led to surgery and were submitted either to lobectomy or pneumonectomy. Perioperative mortality reached 5.6%. Invasive physiotherapy diminished perioperative morbidity but hospitalization was longer ranging from 7 to 14 days. No bronchopleural fistula occurred. The overall free survival ranged from 6 months to 3 years. <bold>Conclusions:</bold> 1. Salvage Surgery is generally indicated for malignant tumours after failure of initial treatment in very selected patients. 2. After careful preoperative assessment along with an experienced team of thoracic surgeons, pulmonologists and oncologists salvage surgery can offer patients favourable outcomes and a better quality of life.