Chest Meeting
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

COPYRIGHT © 2003 by the American College of Chest Physicians.
This Article
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sakamoto, T.
Right arrow Articles by Tsubota, N.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Sakamoto, T.
Right arrow Articles by Tsubota, N.

Thoracic Surgery: Advances in the Treatment of Lung Cancer


Monday, October 27, 2003

2:30 PM - 4:00 PM

Late Critical Complications After Surgery Following Induction Chemoradiotherapy for Lung Cancer

Toshihiko Sakamoto, MD*, Wataru Nishio, MD, Morihito Okada, MD, Kazuya Uchino, MD and Noriaki Tsubota, MD

Hyogo Medical Center for Adults, Department of Thoracic Surgery, Akashi, Japan

PURPOSE: We retrospectively investigated the major complications after pulmonary resection following induction therapy for lung cancer.

METHODS: From 1990 to 2002, 90 patients underwent pulmonary resection after induction therapy. The indications for induction therapy were N2 disease in 56, superior sulcus tumor in 8, involvement of great vessels in 7, small cell carcinoma in 6, chest wall invasion in 6, and miscellaneous in 7. Induction therapy consisted of 2 cycles of platinum-based chemotherapy concurrent with 40 Gy radiation.

RESULTS: There was no postoperative death within 30 days. Major complications occurred in 15 patients. Eight patients experienced them during the same hospitalization as the surgery and 7 did after discharge. Major complications included radiation pneumonitis (n = 10), late bronchial stump dehiscence (n = 3), empyema without fistula (n = 1), and interstitial pneumonia (n = 1). Of the 10 patients who suffered from radiation pneumonitis 3 patients developed contralateral interstitial pneumonia and 2 patients developed bacterial pneumonia within radiation pneumonitis, which was refractory and resulted in empyema. Treatment-related death added up to 7 patients (7.8%), of whom 6 patients died after second admission.

CONCLUSIONS: Major complications in relation to surgery following concurrent chemoradiotherapy can happen in the late postoperative phase, and thus, careful attention should be paid for these patients at an outpatient department. Radiation may play an important role in the development of late morbidity.

CLINICAL IMPLICATIONS: Major complications in relation to surgery following concurrent chemoradiotherapy can happen in the late postoperative phase.

DISCLOSURE: T. Sakamoto, None.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American College of Chest Physicians.