BACKGROUND: The aim of the present study was to evaluate the outcomes of surgical resection, especially bilobectomy, after chemoradiation therapy to treat stage IIIA-N2 non-small-cell lung cancer. METHODS: Data from all patients who underwent surgical resection after neoadjuvant chemoradiation therapy for stage IIIA-N2 non-small-cell lung cancer between 1998 and 2007 were analyzed retrospectively. The chemotherapy regimen consisted of weekly paclitaxel plus cisplatin or weekly paclitaxel plus carboplatin for 5 weeks. The concurrent thoracic radiotherapy dose was 45 Gy over 5 weeks. Surgical resection was planned at around 4 weeks following the completion of neoadjuvant therapy. RESULTS: Of 186 patients who underwent neoadjuvant therapy, 23 bilobectomies, 28 pneumonectomies, and 135 lobectomies were performed. The early postoperative mortality rate (within 30 days after operation) was 7.1, 8.7, and 1.5% for the pneumonectomy, bilobectomy, and lobectomy groups, respectively. The late postoperative mortality rate (within 90 days) of the lobectomy, bilobectomy, and pneumonectomy groups was 5.9, 13, and 10.7%, respectively. Overall survival was significantly higher among patients treated by lobectomy than among those treated by bilobectomy (p = 0.041) or pneumonectomy (p = 0.010). Recurrence was significantly lower in patients treated by lobectomy than in those treated by pneumonectomy (p = 0.034). CONCLUSIONS: Bilobectomy is associated with high operative mortality and poor long-term survival after neoadjuvant concurrent chemoradiotherapy for stage IIIA-N2 non-small-cell lung cancer. The outcomes of bilobectomy were similar to those of pneumonectomy in terms of overall survival, disease-free survival, and postoperative mortality.
BACKGROUND: The aim of the present study was to evaluate the outcomes of surgical resection, especially bilobectomy, after chemoradiation therapy to treat stage IIIA-N2 non-small-cell lung cancer. METHODS: Data from all patients who underwent surgical resection after neoadjuvant chemoradiation therapy for stage IIIA-N2 non-small-cell lung cancer between 1998 and 2007 were analyzed retrospectively. The chemotherapy regimen consisted of weekly paclitaxel plus cisplatin or weekly paclitaxel plus carboplatin for 5 weeks. The concurrent thoracic radiotherapy dose was 45 Gy over 5 weeks. Surgical resection was planned at around 4 weeks following the completion of neoadjuvant therapy. RESULTS: Of 186 patients who underwent neoadjuvant therapy, 23 bilobectomies, 28 pneumonectomies, and 135 lobectomies were performed. The early postoperative mortality rate (within 30 days after operation) was 7.1, 8.7, and 1.5% for the pneumonectomy, bilobectomy, and lobectomy groups, respectively. The late postoperative mortality rate (within 90 days) of the lobectomy, bilobectomy, and pneumonectomy groups was 5.9, 13, and 10.7%, respectively. Overall survival was significantly higher among patients treated by lobectomy than among those treated by bilobectomy (p = 0.041) or pneumonectomy (p = 0.010). Recurrence was significantly lower in patients treated by lobectomy than in those treated by pneumonectomy (p = 0.034). CONCLUSIONS: Bilobectomy is associated with high operative mortality and poor long-term survival after neoadjuvant concurrent chemoradiotherapy for stage IIIA-N2 non-small-cell lung cancer. The outcomes of bilobectomy were similar to those of pneumonectomy in terms of overall survival, disease-free survival, and postoperative mortality.
Authors: W Eberhardt; H Wilke; G Stamatis; M Stuschke; A Harstrick; H Menker; B Krause; M R Müeller; M Stahl; M Flasshove; V Budach; D Greschuchna; N Konietzko; H Sack; S Seeber Journal: J Clin Oncol Date: 1998-02 Impact factor: 44.544
Authors: R Rosell; J Gómez-Codina; C Camps; J Javier Sánchez; J Maestre; J Padilla; A Cantó; A Abad; J Roig Journal: Lung Cancer Date: 1999-10 Impact factor: 5.705
Authors: W T Sause; C Scott; S Taylor; D Johnson; R Livingston; R Komaki; B Emami; W J Curran; R W Byhardt; A T Turrisi Journal: J Natl Cancer Inst Date: 1995-02-01 Impact factor: 13.506
Authors: David W Johnstone; Roger W Byhardt; David Ettinger; Charles B Scott Journal: Int J Radiat Oncol Biol Phys Date: 2002-10-01 Impact factor: 7.038
Authors: D C Betticher; S-F Hsu Schmitz; M Tötsch; E Hansen; C Joss; C von Briel; R A Schmid; M Pless; J Habicht; A D Roth; A Spiliopoulos; R Stahel; W Weder; R Stupp; F Egli; M Furrer; H Honegger; M Wernli; T Cerny; H-B Ris Journal: Br J Cancer Date: 2006-04-24 Impact factor: 7.640