کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2984169 | 1578671 | 2009 | 6 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: POINT: Operative risk of pneumonectomy—Influence of preoperative induction therapy POINT: Operative risk of pneumonectomy—Influence of preoperative induction therapy](/preview/png/2984169.png)
BackgroundPrior data indicate increased perioperative morbidity and mortality in patients receiving induction chemoradiotherapy before pneumonectomy for lung cancer.ObjectiveWe reviewed a consecutive series of pneumonectomies to determine the impact of induction therapy on operative mortality.ResultsOver a 15-year period, 183 patients underwent pneumonectomy for lung cancer. Forty-six received combined preoperative radiochemotherapy (25.2%), and 137 patients underwent resection only. Indications for induction therapy were stage IIB disease in 1, IIIA in 35, IIIB in 8, and IV in 2 patients. Patients receiving induction therapy were younger (mean age 58.4 vs 61.9 years; P = .033), had less heart disease (6.5 vs 26.3%; P = .0035), higher preoperative forced expiratory volume in 1 second (2.48 vs 2.13 L; P = .0018), a lower rate of endobronchial tumor (34.8 vs 67.2%; P = .0002), and underwent intrapericardial procedures more often (71.7 vs 43.1%; P = .0011). Hospital mortality was 4.3 % (2/46) after preoperative therapy and 6.6% (9/137) after resection only (P = .73); the difference in cardiopulmonary morbidity was not significant (51.1% vs 40.4%; P = .22). Induction did not predict hospital mortality after adjustment for a propensity score derived from nonoperative and operative variables correlated with neoadjuvant therapy.ConclusionsA regimen of induction radiation and chemotherapy does not increase the operative mortality of pneumonectomy in carefully selected patients.
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 138, Issue 2, August 2009, Pages 289–294