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


CONCLUSIONS
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.
Doddoli
C
C
Service de Chirurgie Thoracique, Hôpital Sainte-Marguerite, Marseille. CDODDOLI@mail.ap-hm.fr
Thomas
P
P
Reynaud-Gaubert
M
M
Giudicelli
R
R
Papazian
L
L
Fuentes
P
P
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001983:Bronchial Fistula / Q000209:etiology; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000628:therapy*; D002423:Cause of Death; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D017052:Hospital Mortality; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects*; D011014:Pneumonia / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014751:Vindesine / Q000008:administration & dosage; D000077235:Vinorelbine
D016685:Mitomycin; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin; D000077235:Vinorelbine; D014751:Vindesine; D005472:Fluorouracil
Complications post opératoires après radiochimiothérapie ou chimiothérapie des cancers bronchiques.