Atrial Fibrillation after Lung Cancer Surgery: Prediction, Prevention and Anticoagulation Management

Semeraro, G; Meroni, Carlo Ambrogio; Cipolla, Carlo M.; Cardinale, Daniela

doi:10.3390/cancers13164012

Cited by 13 publications

(8 citation statements)

References 93 publications

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“…There are many reasons related to postoperative atrial fibrillation, and the extent and type of thoracic surgery were reported to affect the likelihood of developing atrial fibrillation. According to these studies, pneumonectomies and lobectomies generally carry a greater risk than wedge resection (>15% vs. 5-15%) [23][24]. In our study, 2 patients (9.52%) in group EL developed atrial fibrillation, and there was no difference in the incidence between group EL and group ES.…”

Section: Accepted Manuscript Fistulasupporting

confidence: 41%

Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers

Lianyong,

Fengqing,

Xiao

et al. 2023

Thorac Cardiovasc Surg

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Background The aim of this study was to evaluate the safety and feasibility of simultaneous surgery for patients with primary esophageal and lung cancers. Methods Patients with primary esophageal and lung cancers who underwent simultaneous surgical procedures between January 2016 and January 2022 were retrospectively analyzed. The data of patients who underwent esophagectomy and lobectomy (group EL) were compared with those of patients who underwent esophagectomy and sublobar resection (group ES). Results A total of 21 patients were included with an average age of 64.62 ± 5.24 years. Group EL contained 8 patients and group ES contained 13 patients. All procedures were completed uneventfully with a mean operative time of 251.19 ± 66.93 minutes. Pulmonary complications occurred in six (28.57%) patients. Other complications included anastomotic leakage in 1 patient, pleural effusion requiring drainage in 8 patients, atrial fibrillation in 2 patients, and incision infection in 1 patient. All patients were followed up for 30.23 ± 21.82 months. During the follow-up period, nine patients had a recurrence of cancer and died of tumor progression, and one patient died of a tracheothoracogastric fistula. Complications and mortality in group EL did not increase when compared to those in group ES. Conclusion It is safe and feasible to perform a single-stage surgical procedure for patients with primary esophageal and lung cancers. Simultaneous esophagectomy and lobectomy did not increase postoperative complications or mortality compared with esophagectomy and sublobar resection.

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Section: Accepted Manuscript Fistulasupporting

confidence: 41%

Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers

Lianyong,

Fengqing,

Xiao

et al. 2023

Thorac Cardiovasc Surg

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“…Atrial fibrillation is a common early postoperative complication following lung cancer surgery, with an incidence rate of approximately 10% to 20% [20]. This incidence varies depending on the extent of lung resection: rates are lower for wedge resection (2%-4%), intermediate for lobectomy (10%-15%), and higher for pneumonectomy (over 20%) [21]. Known risk factors for postoperative atrial fibrillation include heart failure, hypertension, a history of myocardial infarction, and male gender [22].…”

Section: Discussionmentioning

confidence: 99%

Safety of Perioperative Maintenance of Antiplatelet Agents in Elderly Patients Undergoing Lung Cancer Surgery

Hong,

Park,

Park

et al. 2024

J Chest Surg

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Background:The maintenance of antiplatelet therapy increases the risk of bleeding during lung cancer surgery. Conversely, the perioperative interruption of antiplatelet therapy may result in serious thrombotic complications. This study aimed to investigate the safety of continuing antiplatelet therapy in the context of lung cancer surgery. Methods: We retrospectively reviewed a cohort of 498 elderly patients who underwent surgery for lung cancer. These patients were categorized into 2 groups: group N, which did not receive antiplatelet therapy, and group A, which did. Group A was subsequently subdivided into group Am, where antiplatelet therapy was maintained, and group Ai, where antiplatelet therapy was interrupted. We compared the incidence of bleeding-related and thrombotic complications across the 3 groups. Results: There were 387 patients in group N and 101 patients in group A (Ai: 70, Am: 31). No significant differences were found in intraoperative blood loss, thoracotomy conversion rates, transfusion requirements, volume of chest tube drainage, or reoperation rates for bleeding control between groups N and A or between groups Am and Ai. The duration of hospital stay was longer for group A compared to group N (7 days vs. 6 days, p=0.005), but there was no significant difference between groups Ai and Am. The incidence of cardiovascular or cerebrovascular complications did not differ significantly between groups Ai and Am. However, group Ai included a severe case of in-hospital ST-elevation myocardial infarction. Conclusion:The maintenance of antiplatelet therapy was found to be safe in terms of perioperative bleeding and thrombotic complications in elderly lung cancer surgery patients.

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“…showed that the incidence of POAF in patients undergoing thoracic surgery for lung cancer was 19%. Moreover, the incidence varies according to the extent of lung resection, being lower for wedge resections (2–4%), intermediate for lobectomies (10–15%), high for pneumonectomies (>20%) ( 25 ). And to a large extent, POAF has been deemed as a benign and temporary complication of lung cancer surgery, with possible mechanisms such as inflammation, oxidative stress, and autonomic nervous system dysfunction ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram of risk factors for new-onset atrial fibrillation in advanced lung cancer patients after non-surgical therapy

Chen

Cao

et al. 2023

Front. Oncol.

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ObjectiveRisk factors of new-onset atrial fibrillation (NOAF) in advanced lung cancer patients are not well defined. We aim to construct and validate a nomogram model between NOAF and advanced lung cancer.MethodsWe retrospectively enrolled 19484 patients with Stage III-IV lung cancer undergoing first-line antitumor therapy in Shanghai Chest Hospital between January 2016 and December 2020 (15837 in training set, and 3647 in testing set). Patients with pre-existing AF, valvular heart disease, cardiomyopathy were excluded. Logistic regression analysis and propensity score matching (PSM) were performed to identify predictors of NOAF, and nomogram model was constructed and validated.ResultsA total of 1089 patients were included in this study (807 in the training set, and 282 in the testing set). Multivariate logistic regression analysis showed that age, c-reactive protein, centric pulmonary carcinoma, and pericardial effusion were independent risk factors, the last two of which were important independent risk factors as confirmed by PSM analysis. Nomogram included independent risk factors of age, c-reactive protein, centric pulmonary carcinoma, and pericardial effusion. The AUC was 0.716 (95% CI 0.661–0.770) and further evaluation of this model showed that the C-index was 0.716, while the bias-corrected C-index after internal validation was 0.748 in the training set. The calibration curves presented good concordance between the predicted and actual outcomes.ConclusionCentric pulmonary carcinoma and pericardial effusion were important independent risk factors for NOAF besides common ones in advanced lung cancer patients. Furthermore, the new nomogram model contributed to the prediction of NOAF.

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Atrial Fibrillation after Lung Cancer Surgery: Prediction, Prevention and Anticoagulation Management

Cited by 13 publications

References 93 publications

Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers

Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers

Safety of Perioperative Maintenance of Antiplatelet Agents in Elderly Patients Undergoing Lung Cancer Surgery

Construction and validation of a nomogram of risk factors for new-onset atrial fibrillation in advanced lung cancer patients after non-surgical therapy

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