Minimally Invasive NSCLC Surgery Improves Chemotherapy Deliveries

April 12, 2007

DURHAM, N.C. -- Minimally invasive surgery for non-small-cell lung cancer can improve the timely and full-dose delivery of adjuvant chemotherapy, according to researchers here.

DURHAM, N.C., April 12 -- Minimally invasive surgery for non-small-cell lung cancer can improve the timely and full-dose delivery of adjuvant chemotherapy, according to researchers here.

Patients who underwent thoracoscopic lobectomy -- compared with the conventional open-chest thoracotomy -- had fewer missed or reduced doses of chemotherapy, found Thomas D'Amico, M.D., of Duke University Medical Center, and colleagues.

A larger proportion of the thoracoscopy patients got 75% or more of their treatment on time and at the planned dose, they reported in the April issue of the Annals of Thoracic Surgery.

"This study showed that patients who had the minimally invasive operation were less likely to experience delays in receiving chemotherapy or a reduction in the amount of chemotherapy we were able to give," Dr. D'Amico said.

"Chemotherapy after surgery has been shown to improve survival in lung cancer patients, so the more effectively we deliver that chemotherapy, the better," he added.

The findings -- some presented last year at the Southern Thoracic Surgical Association meeting in Tucson, Ariz. -- came from a retrospective review of 100 consecutive patients at Duke who had a lobectomy, followed by adjuvant chemotherapy.

Of the 100 patients, 43 had open-chest surgery and 57 had thoracoscopy, the researchers reported.

There were no major differences in postoperative complications but -- as expected -- thoracoscopy patients had a significantly shorter hospital stay (P=0.013), with a median of four days compared with five days in the thoracotomy group.

The thoracoscopy patients were also less likely to be taken back to the operating room for postoperative bleeding (0% versus 7%), which was significant at P=0.04.

Analysis showed that chemotherapy compliance was better in patients undergoing thoracoscopic lobectomy. Specifically:

  • Only 18% of their doses were delayed, compared with 58% of doses in the thoracotomy group, which was significant at P