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.