Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity

Citation
G. Myrdal et al., Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity, EUR J CAR-T, 20(4), 2001, pp. 694-699
Citations number
26
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN journal
10107940 → ACNP
Volume
20
Issue
4
Year of publication
2001
Pages
694 - 699
Database
ISI
SICI code
1010-7940(200110)20:4<694:OALCSF>2.0.ZU;2-6
Abstract
Objective: This study was undertaken to assess mortality, complications and major morbidity during the first 30 days after lung cancer,surgery and to estimate the significance of presurgical risk factors. Methods: The study w as based on all patients referred for surgery for primary lung cancer from 1 January 1987 to 1 September 1999. There were in total 616 patients with p rimary lung cancer. Three-hundred and ninety-four were men and 222 women. P ostoperative events studied were divided into major and minor complications or death during the first 30 days after surgery. The significance of risk factors for an adverse outcome (defined as death or major complication in t he first 30 days postoperatively) was assessed by uni- and multivariate log istic regression analyses. Results: During the study period an increasing n umber of women and of patients older than 70 years underwent surgery. Overa ll 30-day mortality was 2.9, 0.6% after single lobectomy and 5.7% after pne umonectomy. Major complications occurred in 54 patients (8.8%). Fifty-eight patients (9.5%) had an adverse outcome during the first 30 days. Male gend er, smoker, FEV(1)less than or equal to 70% of expected value, squamous cel l carcinoma and pneumonectomy were risk factors predicting adverse outcome in the univariate model. Pneumonectomy and FEV(1)less than or equal to 70%, were the only independently significant factors for adverse outcome. Only pneumonectomy was independently associated with an increased risk for early death. Conclusion: Our results show low mortality and morbidity after lung cancer surgery. However, patients with reduced lung capacity and those und ergoing pneumonectomy should be treated with great care, as they run a cons iderable risk of major complications or death during the first 30 days post operatively. Older age (> 70 years) does not appear to be a contraindicatio n to lung cancer surgery, but patients in this group should undergo careful preoperative evaluation. (C) 2001 Elsevier Science B.V. All rights reserve d.