47 Surgical complications related to perioperative adjuvant chemotherapy in breast cancer. Results of a prospective, controlled, randomized clinical trial

From May 1985 to June 1992, 375 patients (pts) were enrolled in a prospective controlled randomized clinical trial of periop adjuvant chemotherapy (PAC) associated to long-term adjuvant chemoendocrinotherapy in order to test the effectiveness of reducing the time interval between surgery and chemotherapy. Here, the short-term surgical complications related to PAC are reported in order to verify whether such treatment might negatively affect the results of breast cancer surgery. Pts undergoing PAC received with in 48–72 hour following surgery one course of CY (600 mg/sqm), EPI (60 mg/sqm), and 5-FU (600 mg/sqm) (CEF): pN+ pts, who were given perioperative CEF, had five further cycles of CEF alternated with six cycles of CMF (CY 600 mg/sqm, MTX 40 mg/sqm, 5-FU 600 mg/sqm). All other pN+ pts had six cycles of CEF alternated with six cycles of CMF, starting with in 30 days after surgery. No significant difference of postop morbidity was observed in the two groups as regards median hospital stay (8 days), number of out patient dressings (3.5 vs 3), seroma (51 = 26.9% vs 45 = 24.2%), lymphatic drainage (400 vs 409 ml), and postop infections, both local (10 vs 9) and in extraop foci (6 vs 7). The toxicity of the periop CEF was mainly gastrointestinal (nausea and vomiting 55%, stomatitis 3%), with only a small percentage (9%) reaching grade III–IV.