Does chemotherapy increase morbidity and mortality after pneumonectomy?

The impact of chemotherapy on postoperative complications after pneumonectomy remains unclear, and the procedure is often considered as potentially dangerous.

This retrospective review of prospectively collected data included 269 patients operated from January 1, 1998 through December 31, 2007. Group 1 included patients those who received preoperative chemotherapy (PCT) and pneumonectomy (54 patients, 20%), and group 2 included patients who underwent pneumonectomy alone (215 patients, 80%).

Overall 30- and 90-day mortality rates were 5.9% and 8.9%, respectively. Postoperative mortality at 30 days was 5.6% in group 1 and 6% in group 2 (P = 0.16), and 11.1% for group 1 and 8.3% in group 2 at 90 days (P = 0.8). Incidence of postoperative respiratory failure was 3.7% in group 1 and 3.2% in group 2 (P = 0.62); incidence of empyema was 5.5% in group 1 and 2.8% in group 2 (P = 0.1). Incidence of bronchopleural fistula (BPF) was 3.7% in group 1 and 2.8% in group 2 (P = 0.55); risk of BPF was higher following right pneumonectomy (6.1%) versus left pneumonectomy (0%, P = 0.003).

PCT does not significantly increase postoperative morbidity and early mortality after pneumonectomy in our experience.