Factors affecting major morbidity after video-assisted thoracic surgery for lung cancer

Wang, Zhiqiang; Zhang, Jiru; Zhou, Cheng; Li, Xian‐Hua; Wang, Zhenjun; Liu, Chuanxin; Xie, Zongtao

doi:10.1016/j.jss.2014.07.051

Cited by 22 publications

(13 citation statements)

References 23 publications

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“…This could have resulted from lower COPD severity in the study group compared to other studies on this subject. [ 28 ] Kim et al . have shown that the effect of COPD on the incidence of postoperative complications is relatively small in the early stages of the disease and increases with the deterioration of spirometric parameters, hence the absence of statistically significant differences in the study group.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…The pooled frequency of PE in RCTs is 2.3% (66 of 2,903), ranging from 1.3% to 21.4% 12 - 24 , of all the highest rate (21.4%) of PE occur in the process of chemotherapy where nab-paclitaxel was used to treat patients with advanced NSCLC who failed first-line chemotherapy 16 followed by 8% in a RCT for the evaluation of pemetrexed plus cisplatin in combination with or without LY2603618 (a selective checkpoint kinase 1 inhibitor) in patients with advanced nonsquamous NSCLC 12 , impling the incidence of PE in various RCTs for lung cancer patients could be high. The PE rate is lower in lung cancer patients only undergoing lung resection (1.6%, 59 of 3,718, range: 0-2.7%) 25 - 27 , 29 , 34 , 37 , 41 , 43 , 45 , 46 than those only receiving nonsurgical therapy (5.0%, 618 of 12,239, range: 1.3%-21.4%) 11 - 21 , 23 , 24 , 28 , 32 , 33 , 36 , 44 , 51 , yet than those receiving comprehensive therapy (surgical and nonsurgical) (2.5%, 279 of 10,962, range: 0-13.3%) 22 , 30 , 35 , 38 , 39 , 47 - 50 . These results imply that the risk of PE in lung cancer patients receiving nonsurgical therapy is higher than those only undergoing lung resection.…”

Section: Incidence Of Pe In Lung Cancer Patientsmentioning

confidence: 96%

“…These results imply that the risk of PE in lung cancer patients receiving nonsurgical therapy is higher than those only undergoing lung resection. Furthermore, the overall frequency of PE in patients undergoing video-assisted thoracoscopic surgery (VATS) or robotic-assisted video thoracoscopic surgery (RAVTS) for lung cancer is 0.5% varying between 0 and 2% 26 , 27 , 29 , 34 , 37 , 45 , implying VATS or RAVTS is feasible in lung cancer.…”

Section: Incidence Of Pe In Lung Cancer Patientsmentioning

confidence: 99%

Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review

Shang²,

Wang

et al. 2018

J. Cancer

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Pulmonary embolism (PE) is gradually considered to be the third most common disease in the vascular disease category. Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males worldwide. Although initially appearing as distinct entities, lung cancer is a great risk factor for the development of PE. Pulmonary embolism is common in lung cancer patients, with a pooled incidence of 3.7%, and unsuspected pulmonary embolism (UPE) is also non-negligible with a rough rate ranging from 29.4% to 63%. Many risk factors of PE have been detected and could be classified into three categories: lung cancer-related, patient-related, and treatment-related factors. Decreased mean survival time could be significantly observed in lung cancer patients with PE or UPE compared to those only, but suspected PE has higher mortality than UPE. Prophylactic anticoagulant therapy benefit might be highest in patients with stage IV non-small cell lung cancer (NSCLC) or limited small cell lung cancer (SCLC), and heparin seems superior to warfarin for thrombotic prophylaxis. Periodically reassessing the risk-benefit ratio of anticoagulant treatment will be an efficient treatment strategy in lung cancer patients with PE.

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“…1,2 IGTTNB can be performed with a variety of guidance modalities, including fluoroscopy, ultrasound, and computed tomography (CT). 10 In a recent single-institution study that evaluated the costs and complications of 149 patients who underwent video-assisted thoracic surgery (VATS), a type of open lung biopsy, after a diagnosis of lung cancer, the median hospital length of stay (LOS) was 4 days, with a 30-day mortality rate of 0.7%, a morbidity rate of 37.6%, and a mean hospital cost of $18,637 per patient. 2,7,9 IGTTNB also serves as an alternative to open lung biopsy, which is associated with significant morbidity including respiratory failure, postoperative bleeding, infection, continuous air leakage, and cardiac complications, and requires hospital admission.…”

Section: Introductionmentioning

confidence: 99%

Trends in Use and Safety of Image-Guided Transthoracic Needle Biopsies in Patients With Cancer

Accordino

Wright

Buono

et al. 2015

JOP

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Factors affecting major morbidity after video-assisted thoracic surgery for lung cancer

Cited by 22 publications

References 23 publications

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

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

Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review

Trends in Use and Safety of Image-Guided Transthoracic Needle Biopsies in Patients With Cancer

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