ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2008;85:1866-1873. doi:10.1016/j.athoracsur.2008.01.103
© 2008 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Mohamed S. Boudaya
Jean-François Régnard
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Alifano, M.
Right arrow Articles by Régnard, J.-F.
PubMed
Right arrow Articles by Alifano, M.
Right arrow Articles by Régnard, J.-F.
Related Collections
Right arrow Lung - cancer

Original Articles: General Thoracic

Pneumonectomy After Chemotherapy: Morbidity, Mortality, and Long-Term Outcome

Marco Alifano, MDa,b,*, Mohamed S. Boudaya, MDa, Maurizio Salvi, MDa, Jean-Yves Collet, MDa, Carmen Dinu, MDc,d, Sophie Camilleri-Broët, MDb,c,d, Jean-François Régnard, MDa,d

a Department of Thoracic Surgery, Hôtel Dieu Hospital, AP-HP, Paris, France
c Department of Pathology, Hôtel Dieu Hospital, AP-HP, Paris, France
b JE2492 Institut National de la Santé et de Recherche Médicale (INSERM), University Paris-Sud, Paris, France
d Faculty of Medicine Paris-Descartes, Paris, France

Accepted for publication January 17, 2008.

* Address correspondence to Dr Alifano, Unité de Chirurgie Thoracique, Hôtel Dieu, 1, Place du parvis Notre-Dame, Paris, Cedex 75181, France (Email: marcoalifano{at}yahoo.com).

Presented at the Forty-fourth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2008.

Background: Results of pneumonectomy after chemotherapy are controversial, and the procedure is often considered as potentially dangerous.

Methods: Records of patients who underwent pneumonectomy after chemotherapy for non-small cell lung cancer in a single institution in a 6-year period were reviewed retrospectively.

Results: One hundred eighteen patients had pneumonectomy after chemotherapy. Indications for preoperative chemotherapy were N2 disease, 74; potentially resectable T4 disease, 17; doubtful resectability, 18; stage IV disease (nodule on another ipsilateral lobe), 4; and participation in a randomized trial on induction chemotherapy in initial stages, 5. Chemotherapy protocols were platinum-based. Imaging reevaluation showed complete, partial, minor response, and disease stability in 0, 24, 39, and 55 patients, respectively. Operative mortality was 5.9% (7 of 118), consisting of 4 of 54 after pneumonectomy, and 3 of 64 after left pneumonectomy. Bronchopleural fistula caused one death. No factor among those evaluated (sex, age, comorbidities, forced expiratory volume in 1 second, symptoms, side and location of tumor; indication for operation, number of cycles, and response to chemotherapy; extent of resection, TNM status, pathologic stage) predicted postoperative death. Median and overall 5-year survival was 22 months and 23.7%, respectively. At univariate analysis, pathologic stage, T status, and the occurrence of postoperative complications influenced 5-year survival. At multivariate analysis, T status (p = 0.0054), the occurrence of postoperative complications (p = 0.0015), and clinical response to induction chemotherapy (p = 0.028) were identified as independent predictors of 5-year survival.

Conclusions: Pneumonectomy after chemotherapy has acceptable mortality. Long-term results are encouraging.






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
Copyright © 2008 by The Society of Thoracic Surgeons.