Document Detail


Induction chemotherapy before sleeve lobectomy for lung cancer: immediate and long-term results.
MedLine Citation:
PMID:  19932225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Induction chemotherapy does not increase the morbidity and mortality rates of bronchoplastic procedures, but the long-term efficiency remains unclear. The purpose of this retrospective study was to analyze the impact of chemotherapy on resectability and long-term survival. METHODS: From 1984 to 2005, 159 consecutive patients with non-small cell lung cancer underwent sleeve lobectomy without (n = 117) or with induction chemotherapy (n = 42). Indications for chemotherapy were N2 lymph node involvement (n = 15), T3 or T4 tumor invasion with doubtful resectability (n = 13), need for tumor size reduction (n = 8), lung function precluding pneumonectomy (n = 4), and brain metastasis (n = 2). None of the patients received induction radiation therapy. We studied tumor characteristics and immediate and long-term results in both groups. RESULTS: Clinical stage III was predominant in the induction chemotherapy group whereas stage II was predominant in the surgery-only group. Complication rates in the induction chemotherapy group and in the surgery-only group were 23.8% and 24.7%, respectively. We observed a greater rate of 1-month-delay smoking cessation before surgery in the induction chemotherapy group (40% versus 22%). The 5-year survival rates were 65.4% in the surgery-only group and 73.4% in the induction chemotherapy group (p = 0.5). The tumor size in the induction chemotherapy group was lower (17.5 versus 30.6 mm; p = 0.01), which reflected the positive impact of chemotherapy on sleeve resection feasibility. CONCLUSIONS: Induction chemotherapy before sleeve lobectomy achieves good long-term results. Tumor reduction and limited resection feasibility seemed to be increased, which justify further prospective trials.
Authors:
Patrick Bagan; Pascal Berna; Emmanuel Brian; Flora Crockett; Fran??oise Le Pimpec-Barthes; Antoine Dujon; Marc Riquet
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  88     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1732-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic Surgery, Georges Pompidou European Hospital, Paris University, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / therapeutic use*
Bronchoscopy
Female
Follow-Up Studies
Humans
Lung Neoplasms / diagnosis,  drug therapy*,  surgery
Male
Middle Aged
Neoplasm Staging
Pneumonectomy / methods*
Preoperative Care / methods*
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents
Comments/Corrections
Comment In:
Ann Thorac Surg. 2009 Dec;88(6):1736   [PMID:  19932226 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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