Impact of neoadjuvant therapy on postoperative complications in non-small-cell lung cancer patients subjected to anatomic lung resection

• Published in: European journal of surgical oncology 2022-09, Vol.48 (9), p.1947-1953
• Main Authors: Cabañero Sánchez, Alberto, Muñoz Molina, Gemma María, Fra Fernández, Sara, Muriel García, Alfonso, Cilleruelo Ramos, Angel, Martínez Hernández, Néstor, Hernando Trancho, Florentino, Moreno Mata, Nicolás, Valiente, Borja Aguinagalde de, Alonso, Sergio Amor, Arrarás, Miguel Jesús, Blanco Orozco, Ana Isabel, Collado, Marc Boada, Nadal, Sergio Bolufer, Sánchez, Alberto Cabañero, Vázquez, Isabel Cal, Caja, Sergi Call, Ramos, Ángel Cilleruelo, Loscertales, Miguel Congregado, Carrasco, Silvana Crowley, Flor, Raúl Embún, Martín, Elena Fernández, Fibla Alfara, Juan José, Barajas, Santiago García, García Jiménez, Maria Dolores, García Prim, Jose María, García Salcedo, Jose Alberto, Giraldo Ospina, Carlos Fernando, Gómez de Antonio, David, Hernández, María Teresa Gómez, Gelbenzu Zazpe, Juan José, Ferrández, Jorge Henández, Illana Wolf, Jennifer D., Abularach, Alberto Jauregui, López, Marcelo Jiménez, Maestre, Unai Jiménez, García, Cipriano López, Sanz, Iker López, Hernández, Néstor Martínez, Téllez, Elisabeth Martínez, Collado, Lucía Milla, Poce, Roberto Mongil, Moradiellos Díez, Francisco Javier, Balsalobre, Ramón Moreno, Mata, Nicolás Moreno, Moreno Merino, Sergio B., Fornell, Carme Obiols, Valenzuela, Florencio Quero, Ramírez Gil, María Elena, Izquierdo, Ricard Ramos, Recuero Díaz, José Luis, Vázquez, Eduardo Rivo, Fuster, Alberto Rodríguez, Marcos, Rafael Rojo, Crespo, Iñigo Royo, Lorente, David Sánchez, Moreno, Laura Sanchez, Romero, Julio Sesma, Adiego, Carlos Simón, Trujillo Reyes, Juan Carlos
• Format: Article
• Language: English
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2022.03.008

To study the impact of neoadjuvant therapies on postoperative complications and mortality among non-small-cell lung cancer (NSCLC) patients subjected to anatomic lung resection and included in the Spanish cohort of the video-assisted thoracic surgery (GE-VATS) multicenter database. The study included a total of 3085 patients from 33 centers between December 2016 and March 2018. We performed a comparative analysis of the complications and mortality in patients who received neoadjuvant therapies (n = 263) versus those who did not (n = 2822). A propensity score-matched analysis was used to adjust for potential confounders. Association between exposure in two groups and outcomes were estimated by logistic regression weighted by inverse of probability of receiving the treatment that actually received. In the unadjusted analysis, the chemotherapy (CT) and chemoradiotherapy (CRT) group presented a higher frequency of ICU readmissions, reinterventions, empyema, cardiovascular complications, a greater frequency of atrial fibrillation, and an increased need for blood product transfusions. In the adjusted group, CT and CRT patients had a higher rate of cardiovascular complications (CT p = 0.002; OR 2.29; 95% CI 1.34–3.94 and CRT p = 0.001; OR 2.90; 95% CI 1.52-5-52), arrhythmias (CT p = 0.013; OR 2.23; 95% CI 1.18–4.20 and CRT p = 0.046; OR 2.22; 95% CI 1.01–4.90) and transfussions (CT p = 0.042; OR 2.95; 95% CI 1.04–8.35 and CRT p