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World Journal of Surgery

Published in:

01-05-2012

Risk Associated with Bilobectomy after Neoadjuvant Concurrent Chemoradiotherapy for Stage IIIA-N2 Non-small-cell Lung Cancer

Authors: Jong Ho Cho, Jhingook Kim, Kwhanmien Kim, Young Mog Shim, Hong Kwan Kim, Yong Soo Choi

Published in: World Journal of Surgery | Issue 5/2012

Abstract

Background

The aim of the present study was to evaluate the outcomes of surgical resection, especially bilobectomy, after chemoradiation therapy to treat stage IIIA-N2 non-small-cell lung cancer.

Methods

Data from all patients who underwent surgical resection after neoadjuvant chemoradiation therapy for stage IIIA-N2 non-small-cell lung cancer between 1998 and 2007 were analyzed retrospectively. The chemotherapy regimen consisted of weekly paclitaxel plus cisplatin or weekly paclitaxel plus carboplatin for 5 weeks. The concurrent thoracic radiotherapy dose was 45 Gy over 5 weeks. Surgical resection was planned at around 4 weeks following the completion of neoadjuvant therapy.

Results

Of 186 patients who underwent neoadjuvant therapy, 23 bilobectomies, 28 pneumonectomies, and 135 lobectomies were performed. The early postoperative mortality rate (within 30 days after operation) was 7.1, 8.7, and 1.5% for the pneumonectomy, bilobectomy, and lobectomy groups, respectively. The late postoperative mortality rate (within 90 days) of the lobectomy, bilobectomy, and pneumonectomy groups was 5.9, 13, and 10.7%, respectively. Overall survival was significantly higher among patients treated by lobectomy than among those treated by bilobectomy (p = 0.041) or pneumonectomy (p = 0.010). Recurrence was significantly lower in patients treated by lobectomy than in those treated by pneumonectomy (p = 0.034).

Conclusions

Bilobectomy is associated with high operative mortality and poor long-term survival after neoadjuvant concurrent chemoradiotherapy for stage IIIA-N2 non-small-cell lung cancer. The outcomes of bilobectomy were similar to those of pneumonectomy in terms of overall survival, disease-free survival, and postoperative mortality.

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Title: Risk Associated with Bilobectomy after Neoadjuvant Concurrent Chemoradiotherapy for Stage IIIA-N2 Non-small-cell Lung Cancer
Authors: Jong Ho Cho
Jhingook Kim
Kwhanmien Kim
Young Mog Shim
Hong Kwan Kim
Yong Soo Choi
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 5/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1472-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk Associated with Bilobectomy after Neoadjuvant Concurrent Chemoradiotherapy for Stage IIIA-N2 Non-small-cell Lung Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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