| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;72:885-888
© 2001 The Society of Thoracic Surgeons
a Department of Cardiac and Thoracic Surgery, Vanderbilt University Hospital, Nashville, Tennessee, USA
Accepted for publication May 9, 2001.
Address reprint requests to Dr Roberts, Department of Cardiac and Thoracic Surgery, Vanderbilt University Hospital, 2986 Vanderbilt Clinic, Nashville, TN 37232
e-mail: bob.roberts{at}mcmail.vanderbilt.edu
Background. Neoadjuvant chemotherapy before resection is the standard of care for stage IIIA non–small cell lung cancer in many institutions. Further, neoadjuvant therapy is being studied in earlier stage lung cancer and may be applied more broadly in the future. There is little information about the effect of preoperative chemotherapy on the perioperative complications and mortality after lung resection.
Methods. All patients undergoing anatomic resection after neoadjuvant chemotherapy by a single surgeon at a single institution were compared with patients undergoing similar resections without preoperative chemotherapy. Complications were analyzed as life-threatening (pneumonia, emergency surgery, transfer to the intensive care unit, or intubation), major (prolonging hospital stay but not necessarily dangerous), and minor. The incidence of life-threatening complications, major complications, reintubation, tracheostomy, and mortality were analyzed to determine whether neoadjuvant chemotherapy might have an effect on these complications. Mortality was defined as hospital mortality. Two-tailed Student’s t test was used to analyze differences in means and 
2 to determine differences in proportions. Differences less than 0.05 were considered significant.
Results. Thirty-four patients underwent resection after neoadjuvant chemotherapy, and 67 patients underwent resection without preoperative therapy. No differences between the two groups in age, pulmonary function, or comorbid diseases were found. The patients receiving chemotherapy did have a more advanced stage (2.52 versus 1.55, p < 0.0001). Striking increases were found in incidence of life-threatening complications (6.0% versus 26.5%, p = 0.0036), major complications (19.4% versus 47.1%, p = 0.0037), reintubation (3.0% versus 17.6%, p = 0.0093), and tracheostomy (0% versus 11.8%, p = 0.0042) in those patients who received preoperative chemotherapy. There was no hospital mortality. However, 2 (neoadjuvant) patients died within 90 days after discharge from the hospital of pneumonia and pulmonary embolus. This difference was also significant (0% versus 5.89%, p = 0.045).
Conclusions. Neoadjuvant carboplatin and Taxol increased the perioperative life-threatening complications in this cohort of patients compared with a similar cohort undergoing operations by the same surgeon in the same institution. The most common life-threatening complication in patients receiving induction chemotherapy was the failure to respond to antibiotics given for pneumonia. Strategies to prevent these complications will be important, especially if chemotherapy before resection becomes the standard for earlier stages of non–small cell lung cancer.
This article has been cited by other articles:
|
|
 |
|
  T. Gudbjartsson, E. Gyllstedt, A. Pikwer, and P. Jonsson Early surgical results after pneumonectomy for non-small cell lung cancer are not affected by preoperative radiotherapy and chemotherapy. Ann. Thorac. Surg., August 1, 2008; 86(2): 376 - 382. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Zhong, X. Yang, J. Bai, J. Yang, C. Manegold, and Y. Wu Complete mediastinal lymphadenectomy: the core component of the multidisciplinary therapy in resectable non-small cell lung cancer. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 187 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Wright, H. A. Gaissert, J. D. Grab, S. M. O'Brien, E. D. Peterson, and M. S. Allen Predictors of prolonged length of stay after lobectomy for lung cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk-adjustment model. Ann. Thorac. Surg., June 1, 2008; 85(6): 1857 - 1865. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Robinson, J. C. Ruckdeschel, H. Wagner Jr, and C. W. Stevens Treatment of Non-small Cell Lung Cancer-Stage IIIA: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 243S - 265S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W Weder, R. Stahel, J Bernhard, S Bodis, P Vogt, P Ballabeni, D Lardinois, D Betticher, R Schmid, R Stupp, et al. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma Ann. Onc., July 1, 2007; 18(7): 1196 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Venuta, M. Anile, D. Diso, M. Ibrahim, T. De Giacomo, M. Rolla, V. Liparulo, and G. F. Coloni Operative complications and early mortality after induction therapy for lung cancer Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 714 - 717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Pompeo, F. Tacconi, and T. C. Mineo Flexible Videopericardioscopy in cT4 Nonsmall-Cell Lung Cancer With Radiologic Evidence of Proximal Vascular Invasion Ann. Thorac. Surg., February 1, 2007; 83(2): 402 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Mansour, E. A. Kochetkova, X. Ducrocq, M.-D. Vasilescu, G. Maxant, A. Buggenhout, J.-M. Wihlm, and G. Massard Induction chemotherapy does not increase the operative risk of pneumonectomy! Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 181 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Leo, P. Solli, G. Veronesi, D. Radice, A. Floridi, R. Gasparri, F. Petrella, A. Borri, D. Galetta, and L. Spaggiari Does chemotherapy increase the risk of respiratory complications after pneumonectomy? J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 519 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-i. Takeda, Y. Funakoshi, Y. Kadota, M. Koma, H. Maeda, S. Kawamura, and Y. Matsubara Fall in diffusing capacity associated with induction therapy for lung cancer: a predictor of postoperative complication? Ann. Thorac. Surg., July 1, 2006; 82(1): 232 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-i. Takeda, H. Maeda, T. Okada, T. Yamaguchi, M. Nakagawa, S. Yokota, N. Sawabata, and M. Ohta Results of pulmonary resection following neoadjuvant therapy for locally advanced (IIIA-IIIB) lung cancer. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 184 - 189. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Fujita, N. Katakami, Y. Takahashi, K. Hirokawa, A. Ikeda, C. Tabata, T. Mio, and M. Mishima Postoperative complications after induction chemoradiotherapy in patients with non-small-cell lung cancer. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 896 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, F. Xiume', M. Al Refai, M. Salati, R. Marasco, and A. Sabbatini Gemcitabine-Cisplatin Chemotherapy Before Lung Resection: A Case-Matched Analysis of Early Outcome Ann. Thorac. Surg., June 1, 2006; 81(6): 1963 - 1968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Leo, A. Borri, F. Petrella, R. Gasparri, D. Galetta, G. Veronesi, and L. Spaggiari Preoperative Chemotherapy and Postoperative Complications: A Closer Look Ann. Thorac. Surg., June 1, 2006; 81(6): 2335 - 2335. [Full Text] [PDF]
|
|
|
|
 |
|
 O. Schussler, M. Alifano, H. Dermine, S. Strano, A. Casetta, S. Sepulveda, A. Chafik, S. Coignard, A. Rabbat, and J.-F. Regnard Postoperative Pneumonia after Major Lung Resection Am. J. Respir. Crit. Care Med., May 15, 2006; 173(10): 1161 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Sugimura and P. Yang Long-term Survivorship in Lung Cancer: A Review. Chest, April 1, 2006; 129(4): 1088 - 1097. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-i. Takeda, H. Maeda, M. Koma, Y. Matsubara, N. Sawabata, M. Inoue, T. Tokunaga, and M. Ohta Comparison of surgical results after pneumonectomy and sleeve lobectomy for non-small cell lung cancer.: Trends over time and 20-year institutional experience Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 276 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Matsubara, S.-i. Takeda, and T. Mashimo Risk Stratification for Lung Cancer Surgery: Impact of Induction Therapy and Extended Resection Chest, November 1, 2005; 128(5): 3519 - 3525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Perrot, B. Guibert, P. Mulsant, S. Blandin, I. Arnaud, P. Roy, L. Geriniere, and P.-J. Souquet Preoperative Chemotherapy Does Not Increase Complications After Nonsmall Cell Lung Cancer Resection Ann. Thorac. Surg., August 1, 2005; 80(2): 423 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Patel and J. B. Shrager Which Patients with Stage III Non-Small Cell Lung Cancer Should Undergo Surgical Resection? Oncologist, May 1, 2005; 10(5): 335 - 344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Hellwig, T. P. Graeter, D. Ukena, T. Georg, C.-M. Kirsch, and H.-J. Schafers Value of F-18-fluorodeoxyglucose positron emission tomography after induction therapy of locally advanced bronchogenic carcinoma J. Thorac. Cardiovasc. Surg., December 1, 2004; 128(6): 892 - 899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Endo, Y. Sato, T. Hasegawa, K. Tetsuka, S. Otani, N. Saito, Y. Tezuka, and Y. Sohara Preoperative chemotherapy increases cytokine production after lung cancer surgery Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 787 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kim, T. W. Rice, S. C. Murthy, M. M. DeCamp, C. D. Pierce, D. P. Karchmer, L. A. Rybicki, and E. H. Blackstone Combined bronchoscopy, mediastinoscopy, and thoracotomy for lung cancer: who benefits? J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 850 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Leo, P. Solli, L. Spaggiari, G. Veronesi, F. de Braud, M. E. Leon, and U. Pastorino Respiratory function changes after chemotherapy: an additional risk for postoperative respiratory complications? Ann. Thorac. Surg., January 1, 2004; 77(1): 260 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Betticher, S.-F. Hsu Schmitz, M. Totsch, E. Hansen, C. Joss, C. von Briel, R. A. Schmid, M. Pless, J. Habicht, A. D. Roth, et al. Mediastinal Lymph Node Clearance After Docetaxel-Cisplatin Neoadjuvant Chemotherapy Is Prognostic of Survival in Patients With Stage IIIA pN2 Non-Small-Cell Lung Cancer: A Multicenter Phase II Trial J. Clin. Oncol., May 1, 2003; 21(9): 1752 - 1759. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. H. Hollaus, G. Wilfing, P. N. Wurnig, and N. S. Pridun Risk factors for the development of postoperative complications after bronchial sleeve resection for malignancy: a univariate and multivariate analysis Ann. Thorac. Surg., March 1, 2003; 75(3): 966 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ohta, N. Sawabata, H. Maeda, and H. Matsuda Efficacy and safety of tracheobronchoplasty after induction therapy for locally advanced lung cancer J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 96 - 100. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Scott, J. Howington, and B. Movsas Treatment of Stage II Non-small Cell Lung Cancer Chest, January 1, 2003; 123(1_suppl): 188S - 201S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Vaporciyan, K. W. Merriman, F. Ece, J. A. Roth, W. R. Smythe, S. G. Swisher, G. L. Walsh, J. C. Nesbitt, and J. B. Putnam Jr Incidence of major pulmonary morbidity after pneumonectomy: association with timing of smoking cessation Ann. Thorac. Surg., February 1, 2002; 73(2): 420 - 426. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
