[Postoperative complications after radiochemotherapy or chemotherapy for bronchial cancers].

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the risk of lung cancer surgery, following induction chemo and/or radiotherapy.

METHODS:

This retrospective study included 69 patients treated from January 1990 to January 1998 for a primary lung cancer in whom surgery had been performed after induction treatment. Surgery had not been considered initially for the following reasons: N2 disease (IIIA; n = 25), temporary functional impairment (2 stages IB and 2 stages IIIA [N2]; n = 4); doubtful resectability (stage IIIB [T4]; n = 40). The medical regimen resulted in combined radio-chemotherapy in 43 patients who received 2 to 4 cycles of chemotherapy (average = 2.9 +/- 0.8 cycles) and 43 +/- 8 Gy (20 to 60 Gy), or chemotherapy alone in 26 patients (3 +/- 0.7 cycles).

RESULTS:

Exploratory thoracotomy was performed in 4 patients (6%). The in-hospital mortality was 9% (n = 6) from respiratory origin in all cases. There were 4 reoperations (6%): 3 for bronchial fistula and 1 for bleeding. Thirty five patients (51%) required blood transfusion (4.5 +/- 3.8 cell packs). The incidence of early and delayed bronchial fistula after pneumonectomy was 15%. Thirteen patients had a postoperative pneumonia (19%).

CONCLUSION:

Surgery for lung cancer after induction chemo and/or radiotherapy is associated with an increased risk. While the mortality seems "acceptable", the morbidity rate however is high.

• Authors: C Doddoli, P Thomas, M Reynaud-Gaubert, R Giudicelli, L Papazian, P Fuentes
• Journal: Revue des maladies respiratoires (Rev Mal Respir) Vol. 17 Issue 6 Pg. 1081-7 (Dec 2000) ISSN: 0761-8425 [Print] France
• Vernacular Title: Complications post opératoires après radiochimiothérapie ou chimiothérapie des cancers bronchiques.
• PMID: 11217503 (Publication Type: Journal Article)

Chemical References

• Mitomycin
• Vinblastine
• Etoposide
• Cisplatin
• Vinorelbine
• Vindesine
• Fluorouracil

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Bronchial Fistula (etiology)
• Carcinoma, Bronchogenic (mortality, therapy)
• Cause of Death
• Cisplatin (administration & dosage)
• Etoposide (administration & dosage)
• Female
• Fluorouracil (administration & dosage)
• Hospital Mortality
• Humans
• Lung Neoplasms (mortality, therapy)
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Neoplasm Staging
• Pneumonectomy (adverse effects)
• Pneumonia (etiology)
• Radiotherapy, Adjuvant (adverse effects)
• Reoperation
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Vinblastine (administration & dosage, analogs & derivatives)
• Vindesine (administration & dosage)
• Vinorelbine