Pneumonectomy for lung cancer: does induction chemotherapy influence postoperative outcome?

OBJECTIVES: Induction chemotherapy before pneumonectomy (particularly in the case of right resection) has been reported to increase postoperative morbidity and mortality. The aim of the present work was to evaluate the influence of neoadjuvant treatment on postoperative outcome following pneumonectomy. METHODS: from January 1998 to May 2003, 163 patients underwent pneumonectomy for lung cancer, 67 after induction chemotherapy (group A), 96 patients with no chemotherapy (group B). Major postoperative morbidity and 30-days mortality were analysed. Statistical comparisons were performed by univariate and multivariate methods for logistic regression model. RESULTS: 95% of patients in group A received cisplatin-based chemotherapy. In this group there were 34 right and 33 left pneumonectomies. The rate of extended pnemonectomy was higher in group A (p=0.017). Overall major morbidity and mortality were 13% (n=22) and 4.3% (n=7) respectively. Major complications occurred in 15% (n=10/67) and 12.5% (n=12/96) of cases, and 30-day mortality was 1% (n=1/67) and 6% (6/96) in group A and B, respectively. No significant differences in morbidity and mortality were found according to the group of patients and the side of pneumonectomy. CONCLUSIONS: Pneumonectomy for lung cancer is associated with acceptable overall morbidity and mortality, and induction chemotherapy is not associated with a significantly increased risk.