title: Gemcitabine-cisplatin chemotherapy before lung resection: a case-matched analysis of early outcome.
abstract: BACKGROUND
  The objective of the present study was to assess whether neoadjuvant chemotherapy with gemcitabine and cisplatin was associated with an increased incidence of morbidity and mortality after major lung resection for lung cancer.
  
  
  METHODS
  We analyzed 570 patients who underwent lobectomy or pneumonectomy for nonsmall-cell lung cancer at our institution from January 2000 through June 2005. Of these, 70 patients underwent three cycles of gemcitabine-cisplatin chemotherapy before operation for locally advanced disease. Propensity scores were constructed to match those patients undergoing neoadjuvant chemotherapy and lung resection with those undergoing surgery alone. The propensity score analysis yielded two groups of 70 well-matched pairs that were compared in terms of baseline characteristics and early outcome (morbidity, mortality, length of postoperative stay, intensive care unit admission).
  
  
  RESULTS
  The two case-matched groups had similar morbidity (p = 0.8), mortality (p = 0.4), perioperative blood transfusions (p = 0.8) and intensive care unit admission rates (p = 0.8). Likewise, the length of postoperative stay did not differ between the groups (p = 0.9).
  
  
  CONCLUSIONS
  Gemcitabin-cisplatin neoadjuvant chemotherapy appears to be safe before major lung resection. This finding warrants its use for efficacy studies of locally advanced and even early-stage lung cancer.
authors.affiliation: Unit of Thoracic Surgery, Umberto I Regional Hospital, Ancona, Italy. alexit_2000@yahoo.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Xiume'
authors.forename: Majed
authors.initials: M
authors.lastname: Al Refai
authors.forename: Michele
authors.initials: M
authors.lastname: Salati
authors.forename: Rita
authors.initials: R
authors.lastname: Marasco
authors.forename: Armando
authors.initials: A
authors.lastname: Sabbatini
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001803:Blood Transfusion; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000601:surgery; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003422:Critical Care; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011013:Pneumonectomy / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D015983:Selection Bias; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine