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

2022; Elsevier BV; Volume: 48; Issue: 9 Linguagem: Inglês

10.1016/j.ejso.2022.03.008

1532-2157

Alberto Cabañero-Sánchez, Gemma María Muñoz‐Molina, Sara Fra‐Fernández, Alfonso Muriel, Ángel Cilleruelo Ramos, Néstor J. Martínez‐Hernández, Florentino Hernándo, Nicolás Moreno‐Mata, Borja Aguinagalde de Valiente, Sergio Alonso, Miguel Jesús Arrarás, Ana Isabel Blanco Orozco, Marc Boada Collado, Sergio Bolufer Nadal, Alberto Cabañero-Sánchez, Isabel Cal Vázquez, Sergi Call Caja, Ángel Cilleruelo Ramos, Miguel Congregado Loscertales, Silvana Crowley Carrasco, Raúl Embún Flor, Elena Fernández Martín, Juan José Fibla Alfara, Santiago García Barajas, Maria Dolores García Jiménez, José María García-Prim, Jose Alberto García Salcedo, Carlos Fernando Giraldo Ospina, David Gómez de Antonio, María Teresa Gómez-Hernández, Juan José Gelbenzu Zazpe, Jorge Henández Ferrández, Jennifer D. Illana Wolf, Alberto Jáuregui Abularach, Marcelo F. Jiménez, Unai Jiménez Maestre, Cipriano López García, Iker López Sanz, Néstor J. Martínez‐Hernández, Elisabeth Martínez Téllez, Lucía Milla Collado, Roberto Mongil Poce, Javier Moradiellos, Ramón Moreno Balsalobre, Nicolás Moreno‐Mata, Sergio B. Moreno Merino, Carme Obiols Fornell, Florencio Quero‐Valenzuela, Maria Elena Ramírez Gil, Ricard Ramos-Izquierdo, José Luis Recuero Díaz, Eduardo Rivo Vázquez, Alberto Rodríguez Fuster, Rafael Rojo Marcos, Íñigo Royo Crespo, David Sánchez Lorente, Laura Moreno, Julio Sesma Romero, Carlos Simón, Juan Carlos Trujillo Reyes,

Radiomics and Machine Learning in Medical Imaging

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 < 0.001; OR 7.74; 95% CI 3.01-19-92).Based on our series, neoadjuvant CT and CRT were associated with a higher rate of cardiovascular complications, arrhythmias and transfussions in patients with NSCLC subjected to anatomic lung resection.