Thoracoscopic lobectomy is associated with superior compliance with adjuvant chemotherapy in lung cancer.
BACKGROUND
Although the survival benefit of adjuvant chemotherapy for nonsmall-cell lung cancer has been proved, 50% to 86% of patients received all planned cycles of chemotherapy. A thoracoscopic procedure may enable more effective administration of adjuvant chemotherapy than a thoracotomy. However, a well-balanced comparison is lacking.


METHODS
Patients who underwent pulmonary resection and received platinum-based double adjuvant chemotherapy for nonsmall-cell lung cancer were identified from a prospective database. A propensity score-matched analysis was performed to obtain a well-balanced comparison between thoracoscopy and thoracotomy to determine compliance of adjuvant chemotherapy.


RESULTS
Seventy-four patients (group A) with thoracoscopy and 278 patients with thoracotomy received adjuvant chemotherapy. Through 1:1 matching, 74 patients (group B) were selected from the thoracotomy group. A higher percentage of group A received four cycles of the planned adjuvant chemotherapy (95.9% versus 82.4%, p = 0.015). There was a trend toward better compliance in group A with four cycles of adjuvant chemotherapy without reduced dose (83.8% versus 73.0%, p = 0.162), and four cycles of adjuvant chemotherapy without delayed or reduced dose (70.3% versus 62.2%, p = 0.385).


CONCLUSIONS
Thoracoscopy showed better compliance with adjuvant chemotherapy after pulmonary resection for nonsmall-cell lung cancer.
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Jin Gu
JG
Lee
Byoung Chul
BC
Cho
Mi Kyung
MK
Bae
Chang Young
CY
Lee
In Kyu
IK
Park
Dae Joon
DJ
Kim
Kyung Young
KY
Chung
D000230:Adenocarcinoma / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D010349:Patient Compliance; D012189:Retrospective Studies; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013906:Thoracoscopy; D013908:Thoracotomy; D016896:Treatment Outcome