Intraoperative intrathoracic chemotherapy and debulking surgery for pulmonary adenocarcinoma with pleural dissemination and no lymph node metastasis

Abstract Objective: assess the feasibility of intraoperative intrathoracic chemotherapy and debulking surgery for pulmonary adenocarcinoma patients with pleural dissemination and no lymph node metastasis. Methods: We retrospectively reviewed medical records of 23 pulmonary adenocarcinoma patients with pleural dissemination and no lymph node metastasis underwent debulking surgery. They were divided into intraoperative intrathoracic chemotherapy (IC) group comprising patients who not intraoperative intrathoracic chemotherapy (NIC) group. Result: There was no significant difference in the adverse reactions of chemotherapy between the two groups. The median progression-free survival (PFS) was 38.0 months (95% CI: 25.6-50.4) in IC group and 24.0months (95% CI: 6.3-41.7) in NIC group, respectively. There was statistical significance between two group (IC vs NIC, p=0.016).The median overall survival (OS) was42.0 months (95% CI: 37.4-46.6) in IC group and was 36.0months (95% CI: 28.4-43.6) in NIC group, respectively. But there were no statistical significance between two groups (p=0.082). Conclusions: Intraoperative intrathoracic chemotherapy might improve PFS for unexpected pulmonary adenocarcinoma with pleural dissemination and no lymph node metastasis in primary tumor resected patients and with less adverse reactions.