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Michael P. Siegenthaler
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Garrett L. Walsh
Ara A. Vaporciyan
W. Roy Smythe
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Ann Thorac Surg 2001;71:1105-1112
© 2001 The Society of Thoracic Surgeons

Original article: general thoracic

Preoperative chemotherapy for lung cancer does not increase surgical morbidity

Michael P. Siegenthaler, MDa, Katherine M. Pisters, MDb, Kelly W. Merriman, MSa, Jack A. Roth, MDa, Stephen G. Swisher, MDa, Garrett L. Walsh, MDa, Ara A. Vaporciyan, MDa, W. Roy Smythe, MDa, Joe B. Putnam, Jr, MDa

a Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
b Department of Thoracic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

Address reprint requests to Dr Putnam, Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 109, Houston, TX 77030
e-mail: putnam{at}mdanderson.org

Presented at the Thirty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 31–Feb 2, 2000.

Background. Preoperative chemotherapy (C+S) for non–small cell lung cancer (NSCLC) has increased in an attempt to improve survival. Patients receiving C+S potentially may have an increase in postoperative morbidity and mortality compared with surgery alone (S). We reviewed our experience with C+S and S in a tertiary referral center.

Methods. Three hundred eighty consecutive patients underwent lobectomy or greater resection for NSCLC between August 1, 1996, and April 30, 1999: 335 patients (259 S; 76 C+S) were analyzed; 45 additional patients were excluded for prior NSCLC, other chemotherapy for other malignancy, or radiation. We compared morbidity and mortality overall, and by subset analysis (clinical stage, pathological stage, procedure, and by protocol use) for both C+S and S patients.

Results. Demographics, comorbidities, and spirometry were similar. We noted no significant difference in overall or subset mortality or morbidity including pneumonia, acute respiratory distress syndrome, reintubation, tracheostomy, wound complications, or length of hospitalization.

Conclusions. C+S did not significantly affect morbidity or mortality overall, based on clinical stage, postoperative stage, or extent of resection. The potential for enhanced survival in resectable NSCLC justifies continued study of C+S.




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