2Deparment of Medical Oncology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul-Türkiye
3Deparment of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul-Türkiye DOI : 10.5505/tjo.2022.3534 OBJECTIVE
Adjuvant chemotherapy compliance and full dose delivery of agents are superior after videothoracoscopic Video-Assisted Thoracic Surgery lobectomy (VATS-L) for operable non-small cell lung carcinoma (NSCLC), compared with thoracotomy. Our aim was determining the role of VATS-L on inception timing and percentage of patients provided with the planned chemotherapy regimen.
METHODS
Clinical files of patients undergoing pulmonary resection for NSCLC between January 2010 and January
2018 were reviewed retrospectively. Analyses were performed only on patients receiving sole post-operative
adjuvant chemotherapy subsequent to the final pathology. Chemotherapy protocol was planned
according to Adjuvant Navelbine International Trialist Association trial. Analyzed variables were the
duration between operation and initial chemotherapy day, with the planned and received chemotherapy
doses. Patients with positive N2 nodes necessitating adjuvant RT were excluded from the study.
RESULTS
Eighty-four patients underwent adjuvant chemotherapy for NSCLC, either after videothoracoscopic
surgery (n=36) or thoracotomy (n=48). Patients undergoing VATS-L had a shorter mean length of hospital
stay (4.1 versus 7.3 days; p<0.001), which lead significantly reduced time delay on chemotherapy
commencement (29.1 versus 36.9 days; p<0.005). VATS-L group received 82.9% of planned Cisplatin
and 81.7% of Navelbine doses. In thoracotomy group, compliance to planned doses of Cisplatin and
Navelbine was 77.6% and 75.0%, respectively. Tolerance for both drugs was increased in the VATS-L
group (Cisplatin p=0.004; Navelbine p=0.004).
CONCLUSION
Besides the known advantages of VATS-L over conventional open surgery, our data demonstrated that
it also allows more complete and rapid adjuvant chemotherapy, in terms of treatment initiation timing
and compliance, by enabling quick post-operative recovery.