Impact of previous cardiovascular surgery on postoperative morbidity and mortality after major pulmonary resection for non-small cell lung cancer

Şenbaklavacı, Ömer; Taspinar, Hakan; Hartert, Marc; Vahl, Christian F.

doi:10.1007/s00423-013-1081-6

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…Coronary artery disease was a predictor of postoperative mortality, which is in agreement with the results of Bernard et al who analyzed a cohort of 639 pneumonectomies and found that cardiovascular disease was predictive of postoperative mortality [ 10 ]. Senbaklavaci et al reported no differences in postoperative morbidity or mortality following major pulmonary resection for NSCLC between 31 patients with previous cardiovascular disease and 167 patients with no cardiovascular disease history [ 26 ]. However, only 5 patients in the subgroup of 31 patients with previous cardiovascular disease underwent pneumonectomies; thus the utility of the comparison of these findings to our own is limited.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Risk Score for Predicting Death after Pneumonectomy

et al. 2015

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Pneumonectomy is associated with significant postoperative mortality. This study was undertaken to develop and validate a risk model of mortality following pneumonectomy. We reviewed our prospective database and identified 774 pneumonectomies from a total of 7792 consecutive anatomical lung resections in the years 2003 to 2010 (rate of pneumonectomy: 9.9%). Based on data from 542 pneumonectomies between 2003 and 2007 (i.e., the "discovery set"), a penalized multivariable logistic regression analysis was performed to identify preoperative risk factors. A risk model was developed and validated in an independent data set of 232 pneumonectomies that were performed between 2008 and 2010 (i.e., the "validation set"). Of the 542 patients in the discovery set (DS), 35 patients (6.5%) died after pneumonectomy during the same admission. We developed a risk prediction model for in-hospital mortality following pneumonectomy; that model included age, current alcohol use, coronary artery disease, preoperative leukocyte count and palliative indication as possible risk factors. The risk model was subsequently successfully validated in an independent data set (n = 232) in which 18 patients (7.8%) died following pneumonectomy. For the validation set, the sensitivity of the model was 53.3% (DS: 54.3%), the specificity was 88.0% (DS: 87.4%), the positive predictive value was 26.7% (DS: 22.9%) and the negative predictive value was 95.8% (DS: 96.5%). The Brier score was 0.062 (DS: 0.054). The prediction model is statistically valid and clinically relevant.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Risk Score for Predicting Death after Pneumonectomy

et al. 2015

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“…For previous cardiac surgeries, Senbaklavaci et al showed that patients undergoing cardiovascular operation including coronary revascularisation did not show any difference in overall morbidity, postoperative pneumonia, prolonged air leak, atrial fibrillation or in-hospital mortality compared to patients without history of heart surgery ( 16 ). These findings are similar to our subgroup population.…”

Section: Discussionmentioning

confidence: 99%

Should cardiovascular comorbidities be a contraindication for pulmonary metastasectomy?

Grapatsas¹,

Hassan²,

Semmelmann³

et al. 2022

J Thorac Dis

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Background: Limited information is available about the impact of cardiovascular comorbidities (CVC) on the postoperative course of patients undergoing pulmonary metastasectomy. In this study, we aim to compare the postoperative morbidity, mortality, and the long-term survival of patients with and without CVC undergoing pulmonary metastasectomy (PM).Methods: A retrospective monocentric study was conducted including 760 patients who underwent PM in curative intention. Patients were divided into two groups depending on the presence of CVC. Results:The data from 164 patients with CVC (21.6%) and 596 patients without CVC (78.4%) were investigated. In both groups, zero in-hospital-mortality and limited 30-day mortality was detected.Postoperative complications occurred more often in patients with CVC (N=47, 28.7% vs. N=122, 20.5%, P=0.02). However, most of them were minor (N=37, 22.6% vs. N=93, 15.6%, P=0.03). The presence of multiple CVC (N=18 patients, 40% vs. N=28, 23.9%, P=0.04) and reduced left ventricular function (N=5, 62.5% vs. N=42, 27.1%, P=0.03) were identified as risk factors for postoperative morbidity. Patients with CVC showed reduced overall survival (5-year survival rate: 75.8% vs. 68%, P=0.03). In the multivariate analysis lobectomy [hazard ratio (HR) 0.3, 95% confidence interval (CI): 0.1-0.8, P=0.02] and general vascular comorbidities (HR 2.1, 95% CI: 1.1-3.9, P=0.01) were identified as independent negative prognostic factors.Conclusions: Resection of pulmonary metastases can be performed safely in selected patients with stable CVC. The presence of CVC in patients undergoing PM is associated with reduced overall survival compared to patients without CVC in the long term follow up. However, a prolonged 5-year survival rate of 68% could be achieved.

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“…Previous reports document the surgical results of patients undergoing lung cancer surgery with cardiovascular comorbidities [ 16 – 19 ]. Takenaka et al [ 16 ] reported no increases in the postoperative morbidity and mortality rates and no influence on the long-term results, while Senbaklavaci et al [ 20 ] reported that a CVS history hardly increased morbidity and mortality after major lung resection. In contrast, Ambrogi et al [ 17 ] reported an increase in postoperative morbidity with a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Surgery for non-small cell lung cancer in patients with a history of cardiovascular surgery

et al. 2016

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PurposeTo clarify if previous cardiovascular surgery (CVS) affects the postoperative outcome of surgery for non-small cell lung cancer (NSCLC).MethodsWe reviewed, retrospectively, the medical records of 36 patients with a history of CVS, who underwent lung cancer surgery at a single institution (study group; SG) and compared their characteristics and postoperative outcomes with those of patients without a history of CVS history (control group; CG), and also with those of patients with coexisting cardiovascular diseases in the CG (specified control group; SCG). Finally, we used a thoracic revised cardiac risk index (ThRCRI) to evaluate the risk of perioperative cardiovascular events.ResultsThere was a significant difference in the ThRCRI classifications between the SG and the SCG (p < 0.0001). There were no significant differences in the incidence of intraoperative and postoperative complications between the SG and CG, or between the SG and SCG. The 5-year survival rates of the SG, CG, and SCG were 69.3, 73.9, and 65.4 % in all stages, and 83.5, 82.2, and 70.4 % in stage I, respectively.ConclusionsPrevious CVS did not increase the number of perioperative cardiovascular events in this study and had no significant influence on the prognosis of patients undergoing resection of NSCLC.

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Impact of previous cardiovascular surgery on postoperative morbidity and mortality after major pulmonary resection for non-small cell lung cancer

Cited by 5 publications

References 16 publications

Development and Validation of a Risk Score for Predicting Death after Pneumonectomy

Development and Validation of a Risk Score for Predicting Death after Pneumonectomy

Should cardiovascular comorbidities be a contraindication for pulmonary metastasectomy?

Surgery for non-small cell lung cancer in patients with a history of cardiovascular surgery

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