Induction chemotherapy does not increase the operative risk of pneumonectomy!

Abstract

In opposition to previous reports, induction chemotherapy did not significantly jeopardize post-operative outcome following pneumonectomy in our experience.

Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

“…It suggested that the development of BPF was mainly driven by NCR and NR rather than NC itself, which was consistent with the discoveries from most of the included studies. As some reports indicated, the incidence of BPF even slightly decreased in patients treated with NC (35,37,38,44). However, the pooled OR for NC group appeared an obvious trend towards the increased risk of BPF (OR: 1.857; 95%CI: 0.881-3.911; P = 0.104).…”

“…3B). The summarized outcomes integrating 12 available studies (21,26,34,35,37,38,42,(44)(45)(46)(47)50) revealed the higher frequency of BPF occurred in patients treated with NC compared with those without NC (OR: 1.857; 95%CI: 0.881-3.911). However, the current evidences did not show the significant impact of NC on BPF occurrence after lung cancer surgery (P = 0.104).…”

“…NC was generally applied in most of the included studies. Twelve studies independently analyzed the effects of NC (21,26,34,35,37,38,42,(44)(45)(46)(47)50), another 11 studies analyzed the effects of neoadjuvant chemo-radiation (NCR) (24,(27)(28)(29)32,33,(39)(40)(41)44,49), and another four studies investigated the association between NR and BPF risk (23,46,48,50). Besides, the remaining studies (22,25,30,31,36,43) enrolled both NC cases and NR cases but analyzed them together, without providing any extractable detail on each strategy.…”

“…Thirteen included studies (21,24,(26)(27)(28)(29)32,(37)(38)(39)41,44,45) analyzed the differences in BPF development between the patients undergoing NT followed by operations and those undergoing operations alone (NT + surgery vs. surgery alone) ( Table 2). The other 17 included studies (22,23,25,30,31,(33)(34)(35)(36)40,42,43,(46)(47)(48)(49)(50) classified 12 919 patients (12 919/14 912, ratio = 86.6%) by BPF occurrence, and evaluated the risk factors of BPF based on the patients with BPF and without BPF (BPF vs. non-BPF) ( Table 2).…”

MDT lung cancer care: Input from the Surgical Oncologist

“…One of the roles of the multidisciplinary team is to judge resectability and to determine the optimal surgical procedure based on the collaborative interpretation of imaging findings. While the issue is still under debate, 57 it is generally considered that pneumonectomy should be avoided as much as possible if oncologically appropriate, especially after induction chemoradiotherapy. 52 The multidisciplinary team judges whether pneumonectomy can be avoided in marginal cases, for instance, by safely performing reconstruction of the airway or vessels when a primary tumour or a bulky lymph node exists in the hilum along with N2 disease.…”