Pneumonectomy after neoadjuvant chemotherapy and radiation for XXXX .

@entity1 @entity190 @entity5 @entity900 @entity189 @entity2879
BACKGROUND: Intergroup 0139 Trial suggests an increase in mortality after pneumonectomy in @entity1 receiving preoperative chemotherapy and radiation. We evaluate our outcomes with pneumonectomy after neoadjuvant chemotherapy and radiation. METHODS: Neoadjuvant chemotherapy and radiation consisted of @entity900 50 mg/m2 on days 1, 8, 29, and 36 and @entity2879 50 mg/m2 on days 1-5 and 29-33 given concurrently with 5,040 cGy radiation. From a prospective database, results after pneumonectomy were compared between @entity1 receiving and not receiving neoadjuvant chemotherapy and radiation during the same time period. RESULTS: Over 7 years, 50 pneumonectomies were performed for non-small-cell @entity189 ; 18 received neoadjuvant chemotherapy and radiation (group A) and 32 did not (group B). Comparing group A with group B, there was no significant difference in @entity1 demographics, @entity190 , transfusion requirements or pneumonectomy side. Group A had more @entity1 with stage III disease [17/ 18 (94%) versus 15/32 (47%), P = 0.001] and also more often had vascularized flap for bronchial stump coverage [17/18 (94%) versus 4/32 (13%), P < 0.001]. There was no significant difference in operative morbidity or mortality. Mortality for group A was 0/18 and for group B was 2/32 (6.3%) (P = 0.530). Group A @entity1 with IIIA(N2) disease (n = 13) had median recurrence-free survival of 12.4 months, median overall survival of 25 months, and 3- year overall survival of 22.2%. CONCLUSIONS: Using a multidisciplinary team approach at a tertiary care center, pneumonectomy can be performed successfully after neoadjuvant chemotherapy and radiation for @entity5 . Vascularized flap for bronchial stump coverage may be important in this regard.
