@article{JTD16780,
author = {Abby White and Suden Kucukak and Raphael Bueno and Elliot Servais and Daniel N. Lee and Yolonda Colson and Michael Jaklitsch and Ciaran McNamee and Steven Mentzer and Jon Wee and Scott J. Swanson},
title = {Pneumonectomy is safe and effective for non-small cell lung cancer following induction therapy},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {11},
year = {2017},
keywords = {},
abstract = {Background: Uncertainty surrounds the safety and efficacy of pneumonectomy in the setting of induction chemoradiation for non-small cell lung cancer (NSCLC). We sought to evaluate fifteen years of experience with pneumonectomy with and without induction therapy.
Methods: Over a 15-year period [1999–2014], data were extracted from medical records of patients undergoing pneumonectomy for NSCLC. Primary outcomes were 5-year overall survival and mortality at 30, 60 and 90 days following operation. Morbidity data was also reviewed. Statistical comparisons were performed using the Chi-Square test. Kaplan-Meier curves were compared using the log rank test. Significance was defined as a P value less than 0.05. Patients with a prior cancer history, bilateral lung nodules and oligometastatic disease at presentation were excluded.
Results: After exclusion criteria were applied, 240 patients were analyzed and 137 (57%) underwent induction therapy prior to pneumonectomy. Five-year overall survival was 38.5%. Mortality at 90 days was 7.94%. There was no statistically significant difference in perioperative mortality with the addition of induction therapy. In fact, in the subset of patients with N2 disease (n=65), induction therapy was associated with improved 5-year overall survival (10.7% vs. 32.7%, P=0.014). Thirty-five percent of patients with N2 disease exhibited a complete response in the nodal basin following induction therapy; however, this did not confer a statistically significant overall or disease-free survival benefit.
Conclusions: Pneumonectomy can safely be performed in the setting of induction chemoradiation. In patients with N2 disease, induction therapy may confer a survival benefit when the surgery can be done with limited morbidity and mortality.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/16780}
}