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Morbidity and mortality in the surgery arm of EORTC 08941 trial

EORTC (European Organisation for Research and Treatment of Cancer), Brussels, Belgium.

CORRESPONDENCE: P. Van Schil, Dept of Thoracic and Vascular Surgery, University Hospital of Antwerp, Wilrijkstraat 10, B–2650 Edegem (Antwerp), Belgium. Fax: 32 38214396. E-mail: paul.van.schil@uza.be

Keywords: Chemotherapy, lung cancer, morbidity, mortality, neoadjuvant therapy, surgery

Received: November 7, 2004
Accepted April 30, 2005

Controversial results of surgical treatment after induction chemotherapy, especially in relation to the extent of resection, have previously been reported. Mortality and morbidity were studied in the surgical arm of the European Organisation for Research and Treatment of Cancer (EORTC) 08941 trial.

EORTC 08941 is a multicentre, prospective, randomised, phase-III trial of surgical resection versus radiotherapy in patients with proven stage IIIA-N₂ nonsmall cell lung cancer after an objective response to platinum-based induction chemotherapy. Operative results in the 167 patients randomised in the surgical arm are presented within this study. Among these patients, one switched to the radiotherapy arm and 17 patients did not get any protocol treatment or information is not yet available.

Radical resection with negative surgical margins was obtained in 74 patients (49.7%). In 61 patients (40.9%), a pathological down-staging to N₀ or N₁ was present. Operative 30-day mortality was 4.0%. Post-operative complications were mainly pneumonia, respiratory insufficiency, arrhythmias, air leak, cardiac decompensation, empyema and bronchopleural fistula. In total, 12 (8.1%) patients underwent re-operation due to positive margins, haemothorax, empyema and bronchopleural fistula.

In conclusion, surgical resection after induction chemotherapy in the multicentre European Organisation for Research and Treatment of Cancer trial has yielded acceptable rates of morbidity and mortality.

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