Impact of Neoadjuvant Chemotherapy on Postoperative Complications Following Pneumonectomy

Czech version

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

Overview

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

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