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Impact of Neoadjuvant Chemotherapy on Postoperative Complications Following Pneumonectomy


Authors: A. J. Stolz;  J. Schützner;  T. Haruštiak;  R. Lischke ;  J. Šimonek;  P. Pafko
Authors place of work: III. chirurgická klinika 1. LF UK a FN Praha-Motol, přednosta: prof. MUDr. P. Pafko, DrSc.
Published in the journal: Rozhl. Chir., 2009, roč. 88, č. 5, s. 225-228.
Category: Monothematic special - Original

Summary

Background:
The risks of complications in patients undergoing pneumonectomy after preoperative chemotherapy for nonsmall cell lung cancer remain controversial. We reviewed a consecutive series of patients having undergone pneumonectomy in a single centre.

Material and Methods:
This retrospective study included 292 patients operated from January 1, 1998 through December 31, 2008. Group 1 included patients those who received preoperative chemotherapy and pneumonectmy (57 patients, 19%), and group 2 included patients who underwent pneumonectomy alone (235 patients, 81%). The main objectives were 30-day and 90-day mortality rates, and major postoperative complications.

Results:
There was no statistically significant difference in patients’ age, gender, cardiovascular co morbidity, histology and side of pneumonectomy between these two groups. Overall 30-days and 90-days mortality rates were 5.5 % and 8.6%, respectively. Postoperative mortality at 30 days was 5.2% in group 1 and 5.6 % in group 2 (p = 0.16), and 10.5% for group 1 and 8.1% in group 2 at 90 days (p = 0.8). Incidence of empyema was 5.2 % in group 1 and 3.0 % in group 2 (p = 0.12); incidence of bronchopleural fistula was 3.5 % in group 1 and 3.0% in group 2 (p = 0.10); incidence of postoperative respiratory failure was 3.4% in group 1 and 3.0% in group 2 (p = 0.75).

Conclusion:
Preoperative chemotherapy does not significantly increase postoperative morbidity and early mortality after pneumonectomy in our experience.

Key words:
neoadjuvant chemotherapy – pneumonectomy – morbidity


Zdroje

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8. Leo, F., Solli, P., Veronesi, G., et al. Does chemotherapy increase the risk of respiratory complications after pneumonectomy? J. Thorac. Cardiovasc. Surg., 2006; 132: 519–523.

9. Allen, A. M., Mentzer, S. J., Yeap, B. Y., et al. Pneumonectomy after chemoradiation: the Dana-Farber Cancer Institute/Brigham and Women‘s Hospital experience. Cancer, 2008; 112: 1106–1113.

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11. Bernard, A., Deschamps, C., Allen, M. S., et al. Pneumonectomy for malignant disease: factors affecting early morbidity and mortality. J. Thorac. Cardiovasc. Surg., 2001; 121: 1076–1082.

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 5

2009 Číslo 5
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