Impact of lung function changes after induction radiochemotherapy on resected T4 non-small cell lung cancer outcome.

Détails

ID Serval
serval:BIB_DDD65796959F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Impact of lung function changes after induction radiochemotherapy on resected T4 non-small cell lung cancer outcome.
Périodique
Annals of Thoracic Surgery
Auteur(s)
Perentes J., Bopp S., Krueger T., Gonzalez M., Jayet P.Y., Lovis A., Matzinger O., Ruffieux C., Ris H.B., Letovanec I., Peters S.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
94
Numéro
6
Pages
1815-1822
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Induction radiochemotherapy, followed by resection, for T4 non-small cell lung cancer, has shown promising long-term survival but may be associated with increased postoperative morbidity and death, depending on patient selection. Here, we determined the effect of induction radiochemotherapy on pulmonary function and whether postinduction pulmonary function changes predict hospital morbidity and death and long-term survival.
METHODS: A consecutive prospective cohort of 72 patients with T4 N0-2 M0 non-small cell lung cancer managed by radiochemotherapy, followed by resection, is reported. All patients underwent thoracoabdominal computed tomography or fusion positron emission tomography-computed tomography, brain imaging, mediastinoscopy, echocardiography, ventilation-perfusion scintigraphy, and pulmonary function testing before and after induction therapy. Resection was performed if the postoperative forced expiratory volume in 1 second and diffusion capacity of the lung for carbon monoxide exceeded 30% predicted and if the postoperative maximum oxygen consumption exceeded 10 mL/kg/min.
RESULTS: The postoperative 90-day mortality rate was 8% (lobectomy, 2%; pneumonectomy, 21%; p=0.01). All deaths after pneumonectomy occurred after right-sided procedures. The 3-year and 5-year survival was 50% (95% confidence interval, 36% to 62%) and 45% (95% confidence interval, 31% to 57%) and was significantly associated with completeness of resection (p=0.004) and resection type (pneumonectomy vs lobectomy, p=0.01). There was no correlation between postinduction pulmonary function changes and postoperative morbidity or death or long-term survival in patients managed by lobectomy or pneumonectomy.
CONCLUSIONS: In properly selected patients with T4 N0-2 M0 non-small cell lung cancer, resection after induction radiochemotherapy can be performed with a reasonable postoperative mortality rate and long-term survival, provided the resection is complete and a right-sided pneumonectomy is avoided. Postinduction pulmonary function changes did not correlate with postoperative morbidity or death or with long-term outcome.
Mots-clé
Adult, Aged, Carcinoma, Non-Small-Cell Lung/diagnosis, Carcinoma, Non-Small-Cell Lung/mortality, Chemoradiotherapy, Female, Follow-Up Studies, Forced Expiratory Volume/physiology, Hospital Mortality/trends, Humans, Lung/physiopathology, Lung Neoplasms/diagnosis, Lung Neoplasms/mortality, Magnetic Resonance Imaging, Male, Mediastinoscopy, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Pneumonectomy, Positron-Emission Tomography, Postoperative Care/methods, Prospective Studies, Respiratory Function Tests, Survival Rate/trends, Switzerland/epidemiology, Treatment Outcome
Pubmed
Web of science
Création de la notice
30/10/2012 12:30
Dernière modification de la notice
20/08/2019 17:02
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