Is age over 70 years a risk factor for pneumonectomy?

Pneumonectomy for left-sided non-small cell lung cancer: analysis of 111 cases over 10 years

Background

Pulmonary resection is the preferred therapeutic option for non-small cell lung cancer (NSCLC). Despite the physiological insult, pneumonectomy (PN) may be unavoidable in patients with early-stage central tumors. This study aimed to analyze the management of early-stage left-sided NSCLC by PN.

Methods

This was a prospective observational study of patients with different stages of NSCLC who underwent left PN over a 10-year period. In-hospital morbidity and mortality and long-term survival were calculated.

Results

A total of 111 patients were enrolled (aged 46–80 years). Preoperatively, 53.2% of patients had stage IIIA, 32.4% stage IIB, and 14.4% had stage IIA disease. Postoperatively, the number of patients with stage IIA and IIB decreased while stage IIIA increased. All PNs were radical. The 5- and 10-year survival rates in stage IIA patients were 42.8% and14.2%, respectively, in stage IIB patients were 56.25% and 3.1%, and the 5-year survival in stage IIIA patients was 22. 5%. The overall 1-, 2-, 5-, and 10-year survival rates were 94.6%, 77.47%, 34.23%, and 2.7%, respectively.

Conclusions

The operative mortality, morbidity, and 5-year survival rates of patients with NSCLC after PN matched the international standards. Left PN might be unavoidable for patients with centrally located tumors.

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

BACKGROUND

Postoperative cardiopulmonary complications might be fatal for patients with lung cancer after surgery. The aim of this study was to identify the risk factors of postoperative cardiopulmonary complications in lung cancer patients and get a fitting formula for predicting incidences of cardiopulmonary complications.

METHODS

We conducted a retrospective analysis of 653 patients with a diagnosis of lung cancer who underwent a surgery in the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) from January to December 2014. All patients received lung cancer surgeries. Clinical data was collected for the analysis of the influence factors of cardiopulmonary complication after lung cancer surgeries. The medical statistical analysis program R was used to calculate cardiopulmonary complication probability of classification of quantitative results.

RESULTS

Our work showed that ages, lymphocyte count, smoking history, chronic bronchitis history, operation mode and extubation time were significantly associated with lung infection both in univariate and multivariate survival analysis. And ages, smoking history, arrhythmia of electrocardiogram and operation mode were significantly associated with postoperative arrhythmia both in univariate and multivariate survival analysis. Multiple linear regressions were generated with risk factors by program R software. Finally, we got a fitting formula for predicting cardiopulmonary complications. Risk score for each patient could be obtained by this formula.

CONCLUSIONS

The incidences of pulmonary infection and arrhythmia were high for patients who underwent lung cancer surgery. It is important to discriminate risk factors for each patient for reducing the risk of heart and lung complications. Preoperative quantitative evaluation of cardiopulmonary complication after operation is beneficial to the risk control.

[Retrospective analysis on risk factors of postoperative cardiac arrhythmia in 352 cases lung cancer with senile patients]

BACKGROUND AND OBJECTIVE

Community is quickly turning into the aging period, and lung cancer has become more common in elderly patients with malignant tumor. At present, surgery remains the preferred therapeutic choice. However, it's worth noting that arrhythmia is a common complication during the perioperative period. The aim of this study is to explore the risk factors of arrhythmia in lung cancer patients over the age of 70 years at perioperative periods.

METHODS

We retrospectively analyzed 352 patients who underwent lobectomy or pneumectomy in Chinese PLA General Hospital from July 1997 to May 2008. Chi-square and Logistic regression were performed to analyze the clinical data.

RESULTS

Among 352 elderly patients with lung cancer, 71 cases occurred perioperative arrhythmias. The occurrence rate was 20.2%. The results of multivariate analysis showed that age, cardiovascular disease history, arrhythmia history, cardiac and pulmonary dysfunction before operation, pneumonectomy, operation time were the high risk factors of perioperative arrhythmia.

CONCLUSIONS

More attention should be paid to prevent perioperative arrhythmia in the elderly lung cancer patients.