Preoperative chemotherapy for lung cancer does not increase surgical morbidity

Background. Preoperative chemotherapy (CCS) for non-small cell lung cancer (NSCLC) has increased in an attempt to improve survival. Patients receiving CCS potentially may have an increase in postoperative morbidity and mortal ity compared with surgery alone (S). We reviewed our experience with C+S an d S in a tertiary referral center. Methods. Three hundred eighty consecutive patients underwent lobectomy or g reater resection for NSCLC between August 1, 1996, and April 30, 1999: 335 patients (259 S; 76 C+S) were analyzed; 45 additional patients were exclude d for prior NSCLC, other chemotherapy for other malignancy, or radiation. W e compared morbidity and mortality overall, and by subset analysis (clinica l stage, pathological stage, procedure, and by protocol use) for both CCS a nd S patients. Results. Demographics, comorbidities, and spirometry were similar. We noted no significant difference in overall or subset mortality or morbidity incl uding pneumonia, acute respiratory distress syndrome, reintubation, tracheo stomy, wound complications, or length of hospitalization. Conclusions. C+S did not significantly affect morbidity or mortality overal l, based on clinical stage, postoperative stage, or extent of resection. Th e potential for enhanced survival in resectable NSCLC justifies continued s tudy of C+S. (C) 2001 by The Society of Thoracic Surgeons.