Surgery after radiochemotherapy for stage III lung cancer: postoperative complications and late results.
Fifty-seven stage III lung cancer patients underwent radiochemotherapy and subsequent surgery. Forty radical (R-), six non-radical, and eleven exploratory operations were performed. Pneumonia (five cases), pulmonary insufficiency (one case), bronchial fistula (one case) were the major non-fatal complications. Four deaths due to adult respiratory distress syndrome (ARDS) or pulmonary embolism occurred. Sixty percent of the 10 patients who had no viable tumor at operation survived 3 years, as well as 41% of those who achieved a complete remission by resection and 11% of those with residual disease (R+) after operation. However, the 1- and 2-year survival rates were similar. The main pattern of failure in R- and R+ patients was extra- and intra-RT-field progression, respectively. A slightly higher rate of postoperative complications, with respect to current practice, was observed. However, data lead to argument on the improvement of locoregional control and long-term survival following radical surgery.
Tavecchio
L
L
Department of Thoracic Surgical Oncology, National Cancer Institute, Milan, Italy.
Ravasi
G
G
Bedini
A V
AV
Gramaglia
A
A
Milani
F
F
D002277:Carcinoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D015993:Life Tables; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome