Preoperative Chemotherapy Does Not Increase Complications After Nonsmall Cell Lung Cancer Resection

Perrot, É; Guibert, Benoît; Mulsant, P.; Blandin, S.; Arnaud, Isabelle; Roy, Pascal; Gérinière, L.; Souquet, Pierre-Jean

doi:10.1016/j.athoracsur.2005.02.043

Cited by 54 publications

(41 citation statements)

References 20 publications

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“…(21) The significance of preoperative chemotherapy as a risk factor for postoperative complications remains controversial. (22)(23) Among the 27 patients submitted to neoadjuvant therapy, the rates of postoperative complications and mortality were comparable to those observed among the patients not receiving neoadjuvant treatment.…”

Section: Discussionmentioning

confidence: 66%

Lobectomia por carcinoma brônquico: análise das co-morbidades e seu impacto na morbimortalidade pós-operatória

et al. 2006

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Objective: To analyze the impact that comorbidities have on the postoperative outcomes in patients submitted to lobectomy for the treatment of bronchial carcinoma. Methods: A retrospective study of 493 patients submitted to lobectomy for the treatment of bronchial carcinoma was conducted, and 305 of those patients met the criteria for inclusion in the final study sample. The surgical technique used was similar in all cases. The Torrington-Henderson scale and the Charlson scale were used to analyze comorbidities and to categorize patients into groups based on degree of risk for postoperative complications or death. Results: The postoperative (30-day) mortality rate was 2.9%, and the postoperative complications index was 44%.Prolonged air leakage was the most common complication (in 20.6%). The univariate analysis revealed that gender, age, smoking, neoadjuvant therapy and diabetes all had a significant impact on the incidence of complications. The factors found to be predictive of complications were body mass index (23.8 ± 4.4), forced expiratory volume in one second (74.1 ± 24%) and the ratio between forced expiratory volume in one second and forced vital capacity (0.65 ± 0.1). The scales employed proved efficacious in the identification of the risk groups, as well as in drawing correlations with morbidity and mortality (p = 0.001 and p < 0.001). In the multivariate analysis, body mass index and the Charlson index were found to be the principal determinants of complications. In addition, prolonged air leakage was found to be the principal factor involved in mortality (p = 0.01). Conclusion: Reductions in forced expiratory volume in one second, in the ratio between forced expiratory volume in one second and forced vital capacity, and in body mass index, as well as a Charlson score of 3 or 4 and a Torrington-Henderson score of 3, were associated with a greater number of postoperative complications in patients submitted to lobectomy for the treatment of bronchial carcinoma. Air leakage was found to be strongly associated with mortality.

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Section: Discussionmentioning

confidence: 66%

Lobectomia por carcinoma brônquico: análise das co-morbidades e seu impacto na morbimortalidade pós-operatória

et al. 2006

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“…Risk of induction chemotherapy in surgery with an extent of less than pneumonectomy Despite the absence of randomised trials having as end-point the impact of chemotherapy on the post-operative outcome of resections less than pneumonectomy, recent evidence resulting from retrospective and prospective studies [249][250][251][252][253][254] has shown acceptable morbidity and mortality rates in selected patients.…”

Section: Chemo-radiotherapy In Lung Cancermentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

723

519

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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“…Even though this approach is now well accepted, controversies still exists about the surgical risk related to the administration of PCT. Some studies reported an increased incidence of postoperative complications and mortality, while others observed an early outcome comparable with that of patients receiving surgery alone [1][2][3][4][5][6][7]. However, most studies included patient populations having undergone all types of pulmonary resection and have analyzed all the subsets together on a whole.…”

Section: Introductionmentioning

confidence: 87%

Does chemotherapy increase morbidity and mortality after pneumonectomy?

Alan

Šimonek

Harustiak

et al. 2008

Journal of Surgical Oncology

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Preoperative Chemotherapy Does Not Increase Complications After Nonsmall Cell Lung Cancer Resection

Cited by 54 publications

References 20 publications

Lobectomia por carcinoma brônquico: análise das co-morbidades e seu impacto na morbimortalidade pós-operatória

Lobectomia por carcinoma brônquico: análise das co-morbidades e seu impacto na morbimortalidade pós-operatória

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Does chemotherapy increase morbidity and mortality after pneumonectomy?

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