Impact of Neoadjuvant Chemoradiation on Adverse Events After Bronchial Sleeve Resection
| Autor: | Matthew M. Rochefort, Sam Freyaldenhoven, Sam Fox, Jeffrey Tarascio, M. Blair Marshall, Michael T. Jaklitsch, Luis E. De León, Carlos E. Bravo-Iñiguez, Maria A Rodriguez, Raphael Bueno, Steven J. Mentzer, Scott J. Swanson, Aaron R. Dezube |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Lung Neoplasms Adolescent medicine.medical_treatment Bronchi 030204 cardiovascular system & hematology 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Sleeve resection Medicine Humans Adverse effect Lung cancer Pneumonectomy Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Incidence (epidemiology) Incidence Middle Aged medicine.disease Neoadjuvant Therapy Surgery Increased risk 030228 respiratory system Female Non small cell Cardiology and Cardiovascular Medicine Airway business |
| Zdroj: | The Annals of thoracic surgery. 112(3) |
| ISSN: | 1552-6259 |
| Popis: | We analyzed the association between neoadjuvant chemoradiation in patients undergoing bronchial sleeve resection with the incidence of postoperative pulmonary and airway complications.After instructional review board approval we performed a retrospective review of a prospectively maintained database of 136 patients who underwent sleeve resection in our institution between January 1998 and December 2016. Administration of neoadjuvant chemoradiation treatment was the studied exposure. Outcomes of interest were rates of postoperative pulmonary and airway complications. Nonparametric testing of demographic, surgical, and pathologic characteristics and morbidity was performed. Logistic regression models evaluated postoperative pulmonary complications and airway complications. Analysis was performed using Stata/IC 15.We analyzed 136 patients (18 underwent neoadjuvant chemoradiation), 77 (57%) of whom had non-small cell lung cancer. Postoperative pulmonary complications were observed in 44 of 136 patients (32%). Incidences of pulmonary complications were higher in the neoadjuvant chemoradiation group compared with the non-neoadjuvant radiation group (15/18 patients [83%] vs 29/118 patients [25%], respectively; P .001). Likewise, rates of pneumonia, atelectasis, respiratory insufficiency, bronchial stenosis, prolonged air leak, bronchopleural fistula, and completion pneumonectomy (2/18 [11%]) were higher in the neoadjuvant chemoradiation group, reaching statistical significance in all cases except bronchial stenosis and prolonged air leak. Only neoadjuvant chemoradiation therapy remained significant for postoperative pulmonary and airway complications on logistic regression (both P.05) CONCLUSIONS: Patients who undergo neoadjuvant chemoradiation before sleeve resection are at an increased risk of pulmonary and airway complications. |
| Databáze: | OpenAIRE |
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