Preoperative chemotherapy for lung cancer does not increase surgical morbidity.

Siegenthaler MP, Pisters KM, Merriman KW, Roth JA, Swisher SG, Walsh GL, Vaporciyan AA, Smythe WR, Putnam JB
Ann Thorac Surg. 2001 71 (4): 1105-11; discussion 1111-2

PMID: 11308144 · DOI:10.1016/s0003-4975(01)02406-7

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.

MeSH Terms (22)

Aged Antineoplastic Combined Chemotherapy Protocols Carboplatin Carcinoma, Non-Small-Cell Lung Cisplatin Etoposide Female Follow-Up Studies Humans Lung Neoplasms Male Middle Aged Multivariate Analysis Pneumonectomy Postoperative Care Premedication Reference Values Retrospective Studies Survival Rate Treatment Outcome Vinblastine Vinorelbine

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