PERI-OPERATORY CHEMOTHERAPY DURING RESECT ION OF PULMONARY SARCOMA METASTASIS

The objective of this prospective study was to evaluate the mortality and morbidity of sarcoma pulmonary metastasis resection with continous chemotherapy. Ifosfamide was administered at the daily dose of 1200 m g/m2/24 h. Twenty-six resections of pulmonary sarcoma were performed f rom December 1990 to April 1992. The primary lesion was already resect ed in all patients. Peri-operatory chemotherapy was started 30 minutes before surgery and continued for 6 days. Chemotherapy was associated with an uroprotector, antiemetic drugs and adequate hydration. Patient s had a mean age of 30.6 years. The delay between initial and thoracic surgery was 81 months. The following was performed: tumorectomy (32), wedge (18), lobectomy (7), diaphragm resection (1), left pneumectomy (1). All patients had the 6-days chemotherapy course. None of the pati ents died. Respiratory failure following superinfection, but not neces sitating assisted ventilation, was observed in one case. The following adverse events were noted. nausea (34.6%), uncomplicated cystitis (15 .4%), leucopenia (7.6%), fever (3.8%). Mean duration of hospitalizatio n was 11.8 days. Chemotherapy adverse effects did not result in signif icant morbidity. Bronchial fistula was not observed. Following the res ults of this pilot study, we feel that perioperatory chemotherapy can be added to sarcoma pulmonary metastasis resection surgery without inc reasing patient morbidity and mortality.