Abstract
Background The effects of neoadjuvant therapy on perioperative and postoperative outcomes of
patients with stage IIIA non-small cell lung cancer remain controversial. We investigated
histopathological changes possibly caused by neoadjuvant chemotherapy and their effect
on the tensile forces of pulmonary structures.
Methods A prospective study of 30 patients who had undergone lung resection was performed.
The patients were divided into two groups. Group 1 included those who received neoadjuvant
chemotherapy, and Group 2 included those who underwent surgery alone. Tensile stress
tests were performed on freshly excised vascular and bronchial strips after lung resection.
The pulmonary artery, veins, and bronchi that had not been invaded by the tumor were
histopathologically examined in both groups. Intraoperative and postoperative complications
were recorded.
Results This study showed that the tensile strength of pulmonary vessels and bronchi was
less in the neoadjuvant group than in the control group. There were statistically
significant differences in the tissue strips obtained from arteries, veins, and bronchi
between the two groups. In the chemotherapy group, most cases exhibited extensive
fibrosis. There was no statistically significant difference in complications between
the groups.
Conclusions Neoadjuvant chemotherapy did not increase postoperative morbidity or mortality. The
decreased tensile strength of pulmonary vessels and bronchi after neoadjuvant therapy
should alert thoracic surgeons to possible surgical complications.
Keywords
lung cancer treatment (surgery, medical) - chemotherapy - surgery, complications -
neoadjuvant therapy - lung cancer - oncologic surgery
