We retrospectively investigated the major complications after pulmonary resection following induction therapy for lung cancer.
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.
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.
Major complications in relation to surgery following concurrent chemoradiotherapy can happen in the late postoperative phase.
T. Sakamoto, None.