Morbidity after surgery for non-small cell lung carcinoma is not related to neoadjuvant chemotherapy.

Abstract

To compare postoperative morbidity and mortality rates in two groups of operated non-small cell lung carcinoma patients (NSCLC) with or without induction chemotherapy. This is a case-control study on 42 cases and 42 controls. Cases (Group A) underwent induction chemotherapy. Chemotherapy indications and regimens were variable. Control cases (Group B) were randomly selected among 494 NSCLC comparable patients operated on in the same period of time. The selection criteria for operation were the same in both groups. Dependent outcomes were operative death and complications. Independent selected variables were: age, co-morbidity, predicted postoperative FEV1% (1 s forced expiratory volume in percentage), type of surgery and clinical and pathological staging. All postoperative events and independent variables were prospectively registered. Chi-square and risk calculations on contingence tables and one-way ANOVA have been tested. Both series are comparable in demographics, preoperative variables and type of surgery. No mortality has been registered. In Group A, the overall morbidity was 26.2% (11 out of 42 cases), and in Group B, this was 42.9% (18 out of 42 cases; P=0.084). Morbidity was not related to the type of surgery (pneumonectomy vs. other; P=0.205 in Group A and P=0.08 in Group B). Pathological staging did not influence the postoperative outcome, either in Group A (P=0.72; odds ratio, 1.515; 95% confidence interval (CI), 0.375-6.122) or Group B (P=0.299; odds ratio, 0.4; 95% CI, 0.089-1.797). Induction chemotherapy in NSCLC has no influence on postoperative morbidity.