Comorbidities with non-small cell lung cancer: Is there an interdisciplinary consensus needed to qualify patients for surgical treatment?

Abstract

INTRODUCTION:Radical surgical treatment is the preferred action for patients with early-stage non-small cell lung cancer (NSCLC). Qualification for surgical treatment should consider a risk associated with the effect of comorbidities on the general condition of the patient. The aim of this article was an attempt to identify the risk factors for postoperative complications in patients treated for NSCLC, with a special focus on the coexisting diseases.METHODS:A total of 400 patients with NSCLC were included in this retrospective study. The incidence of postoperative complications (including major complications according to the European Society of Thoracic Surgeons [ESTS]) was analyzed. Factors associated with high risk of postoperative complications were identified.RESULTS:Postoperative complications occurred in 151 patients (39% operated patients), including severe complications according to ESTS in 75 patients (19%). From univariate analysis, risk factors for postoperative complications were arrhythmias, pneumonectomy, and open thoracotomy. According to ESTS, for major complications, the risk factors included age ≥65 years, the presence of comorbidities, hypertension, and arrhythmias. From multivariate analysis, the risk of complications was higher in patients undergoing pneumonectomy and with cardiac arrhythmias, whereas the risk of serious complications according to ESTS was found in people ≥65 years of age and suffering from comorbidities.CONCLUSIONS:The risk of postoperative complications is affected by both surgical factors and the general health of the patient. Elderly patients with chronic disease history, hypertension, and arrhythmias have an increased risk of postoperative complications. Knowledge of these factors will identify a group of patients requiring internal consultation and optimization of preoperative treatment and postoperative follow-up.

Patient, tumor, and healthcare factors associated with regional variability in lung cancer survival: a Spanish high-resolution population-based study

“…The prevalence of tobacco smoking and lung disease was higher in Huelva than in Granada; patients in Huelva were younger and showed lower comorbidity, both which could mean a better prognosis concerning survival [25,26]. However, although older age is associated with a worse prognosis, some studies show tumors in younger patients are more aggressive than in older patients, as has been observed in the present study.…”

Clinicopathological characteristics and prognosis of pulmonary large cell neuroendocrine carcinoma aged ≥65 years

“…Median age at diagnosis of all patients was 66 years (range, 18–94 years). Using median age and previous clinical studies as guides (Brueckl et al, 2018; Feliciano et al, 2018; Hutchins et al, 1999; Lembicz et al, 2018; Lewis et al, 2003), we divided the included patients into two groups based on age: younger (aged <65 years) ( N = 729), and older (aged ≥65 years) ( N = 890) patients.…”

Prognostic Factors Determining Survival of Patients Operated for Non-Small Cell Lung Cancer with Consideration Given to Morphological Parameters of Blood

“…Comorbidities undoubtedly affect the natural course of a neoplastic process. 24 In our study, in order to preoperatively evaluate the patient’s condition and determine the mortality rate, we applied the CCI. The multivariate analysis revealed that the CCI > 4 is a significant independent negative prognostic factor in NSCLC.…”

“…The patient’s general condition and comorbidities are related to an occurrence of postoperative complications 24 and those have significant implications for the patient’s further health condition. 27 Our analysis revealed that postoperative complications significantly shortened the patients’ OS (p= 0.008).…”