The outcome of patients treated with salvage surgery after chemo-radiotherapy for locally advanced non-small cell lung carcinoma

Local relapse or persistent disease after definitive chemo radiotherapy for locally advanced nonsmall cell lung cancer (NSCLC) occurs in 24% to 35% of patients. Patients treated with chemo-radiotherapy or surgery alone have a poor prognosis. Therefore, some authors described salvage surgery after definitive concurrent chemo radiotherapy in the attempt to prolong disease free and overall survival. Although initially considered inoperable, selected patients are evaluated for salvage surgery. Even if it is a challenging operation, when indicated, salvage surgery is technically feasible in centres with dedicated expertise and is leading to acceptable morbidity, mortality, and long-term outcomes, even when extended resections are necessary. Careful patient selection and multidisciplinary meeting are crucial to deciding on salvage lung resection. The literature is mainly in the form of retrospective studies and case series, there is lack of strong evidence and randomized clinical trial, therefore salvage surgery after definitive medical treatment should be offered within a study protocol in order to produce stronger evidence behind its adoption. In this brief review, we evaluate the prognosis of patients treated with salvage surgery after definitive chemo-radiotherapy for locally advanced NSCLC. We also underline the main critical points related with its adoption and