Postoperative complications are linked to poor pre-CCRT lung function

  • Shin S & al.
  • Respir Res
  • 10 Jan 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with stage IIIA/N2 NSCLC with low diffusing capacity of the lung for carbon monoxide (DLco) before neoadjuvant concurrent chemoradiotherapy (CCRT) are significantly more likely to develop a postoperative pulmonary complication (PPC) after CCRT.

Why this matters

  • CCRT followed by surgical resection is the standard treatment for stage IIIA/N2.

Study design

  • 321 patients underwent CCRT followed by surgical resection for stage IIIA/N2 NSCLC.
  • Funding: National Research Foundation of Korea.

Key results

  • 24.6% developed ≥1 PPC.
  • Compared with patients without PPC, those with PPC were more likely to:
    • Be older: 63.3 vs 60.4 years (P=.006).
    • Be male: 89.9% vs 77.7% (P=.017).
    • Have a smoking history: 89.9% vs 77.3% (P=.014).
    • Have undergone more extensive resection: 30.4% vs 16.9% (P=.010).
  • Average DLco decrease after CCRT was 12.3%.
  • PPC frequency was higher in patients with a low DLco before CCRT vs those with normal DLco: 35.3% vs 14.5% (P<.001>
  • Risk increase for any PPC was significantly greater in patients with a low DLco before CCRT than those with normal DLco: incidence rate ratio, 2.14 (95% CI, 1.36-3.36).

Limitations

  • Single-center, retrospective study.