PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE

Objective: in this study, we aimed to analyse the non-small cell lung carcinoma patients who have undergone surgery after neoadjuvant chemo/chemoradiotherapy in regards to recurrences, survival, complication, morbidity and mortality.materials and methods: the data of 90 patients who had surgeries between june 2001 and december 2008 were retropectively evaluated. fifty nine of those 90 patients had neoadjuvant chemotherapy and 31 patients had neoadjuvant chemoradiotherapy. patients were divided into 3 groups; 47 patients were clinical t3/n2, 23 patients were clinical t4 (n0-1), 20 patients were histopatologically proven n2 (t1-3). age, gender, tumor pathology, resection type, complications, mortality and survival rates of the patients were evaluated.results: there were 76 male, 14 female patients in our study group. mean age was 55.3±8.5 (36-75) years. thirty six patients had lobectomy, 11 patients had extended resections with lobectomy, 13 patients had sleeve lobectomy and 30 patients had pneumonectomy operations. major complication and mortality rates were 14.4% and 2.2% respectively. minimal and mean follow-up periods were 24 and 27±18 months respectively. mean survival was calculated as 25±4.6 months (pathological stage i: 35±9.7 months, stage ii: 33±8.5 months, stage iiia: 24±9.7 months, and stage iiib: 14±10.9 months). mean survival was 26±6.7 months in clinical t3/n2 group, 14±2.2 months in t4 group and 41±3.7 months in histopathological n2 group. there was a statistically significant difference in survival times between clinical t3/n2 and histopathological n2 groups (p<0.05).conclusion: lung resections after neoadjuvant therapy can be achieved with acceptable rates of complications, morbidity and mortality. surgery in selected patients with proper mediastinal staging may also provide longer survival