Surgical Resection Following Induction Chemoradiotherapy for Locally Advanced Lung Cancer

Fourteen patients with primary bronchogenic carcinoma, including 6 stage IIIA patients and 7 IIIB disease patients, underwent a pulmonary resection following cisplatin-based chemotherapy concurrent with 40 Gy of irradiation. The operations included 10 lobectomies, a bilobectomy, 2 pneumonectomies and a sleeve lobectomy. Dissection of the branches of the pulmonary artery was difficult, and an angioplastic procedure was employed in 2 patients. The average operating time was 306 minutes, and average blood loss was 338g. All patients were managed routinely, without any special measures. No major postoperative complication occurred, and patients were discharged from 11 to 35 days following surgery. Operative mortality rate was 0%. The median survival time was 36 months, and the 2-year survival rate was 68%. There is usually a tremendous amount of fibrosis in the mediastinum and hilum following induction therapy, and therefore, dissection of the adhesion is difficult. However, with meticulous dissection, it is possible to perform a successful operation without fatal complications