title: Impact of induction treatment on postoperative complications in the treatment of non-small cell lung cancer.
abstract: BACKGROUND
  A main drawback of neoadjuvant chemotherapy is that it may increase operative morbidity and mortality. The aim of this study was to determine the impact of chemotherapy on these complications.
  
  
  METHODS
  Patient data were collected from the Epithor database. From June 2002 to June 2004, 3888 successive observations of surgery for lung cancer have been reported from 51 thoracic surgery departments throughout France. Logistic regression analysis was performed to identify preoperative clinical characteristics of patients with significant postoperative complications.
  
  
  RESULTS
  Of 3888 patients, 555 (14.3%) received induction chemotherapy. The groups were similar with respect to sex and the number of comorbidities. The in-hospital mortality rate was 3.01%. The multivariate analysis allows us to identify age (older than 65 years), sex (male), preoperative clinical score (moderate and severe), surgical procedure (right pneumonectomy and bilobectomy) as significantly associated with in-hospital mortality. No statistical difference was observed according to the delivery or preoperative chemotherapy. In total, 1219 patients (31.4%) had at least one postoperative complication. Using a multivariate analysis, we observed a significant correlation between morbidity and age (older than 65 years), sex (male), presence of comorbidities (two or more), clinical score (moderate), and type of operation (bilobectomy). Preoperative administration of chemotherapy did not significantly influenced postoperative morbidity.
  
  
  CONCLUSIONS
  Preoperative chemotherapy is not associated with an increase in either the mortality rate or major surgical complications. Future randomized trials are warranted to confirm the survival benefit of this strategy.
authors.affiliation: Department of Thoracic Surgery, Rangueil-Larrey University Hospital, Toulouse, France. brouchet.l@chu-toulouse.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Brouchet
authors.forename: Eric
authors.initials: E
authors.lastname: Bauvin
authors.forename: Bertrand
authors.initials: B
authors.lastname: Marcheix
authors.forename: Laurence
authors.initials: L
authors.lastname: Bigay-Game
authors.forename: Claire
authors.initials: C
authors.lastname: Renaud
authors.forename: Jean
authors.initials: J
authors.lastname: Berjaud
authors.forename: Pierre Emmanuel
authors.initials: PE
authors.lastname: Falcoze
authors.forename: Nicolas
authors.initials: N
authors.lastname: Venissac
authors.forename: Dan
authors.initials: D
authors.lastname: Raz
authors.forename: David
authors.initials: D
authors.lastname: Jablons
authors.forename: Julien
authors.initials: J
authors.lastname: Mazières
authors.forename: Marcel
authors.initials: M
authors.lastname: Dahan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents