Lobar lung resection in elderly patients with non-small cell lung carcinoma: impact of cardiac comorbidity on surgical outcome

Şenbaklavacı, Ömer; Taspinar, Hakan; Hartert, Marc; Ergun, Sinem; Keranen, Satu; Vahl, Christian F.

doi:10.4414/smw.2012.13742

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Although the possibility for in-hospital death was estimated to be three times higher for the right-sided pneumonectomy compared to lobectomy or limited lung resection, the risk of death following pneumonectomy or extended resection was not correlated to FEV which was not the case for lobectomy (114). Also, the positive cardiologic history is not a risk factor for increased postoperative morbidity and mortality for the elderly, on the assumption that lung resections will be limited to lobar, segmental or wedge resections (104,106,115,116). However, surgery for both middle and lower lobectomy (bilobectomy) was associated with significant cardio-respiratory postoperative complications compared to lower lobectomy (117).…”

Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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Background: Co-morbidity of primary lung cancer (LC) and heart disease (HD), both requiring surgical therapy, characterizes a high risk group of patients necessitating prompt diagnosis and treatment. The aim of this study is the review of available evidence guiding the management of these patients.Methods: Postoperative outcome of patients operated for primary LC (first meta-analysis) and for both primary LC and HD co-morbidity (second meta-analysis), were studied. Parameters examined in both meta-analyses were thirty-day postoperative mortality, postoperative complications, three-and five-year survival probabilities. The last 36 years were reviewed by using the PubMed data base. Thirty-seven studies were qualified for both meta-analyses. Results:The pooled 30-day mortality percentages (%) were 4.16% [95% confidence interval (CI): 2.68-5.95](first meta-analysis) and 5.26% (95% CI: 3.47-7.62) (second meta-analysis). Higher percentages of squamous histology and lobectomy, were significantly associated with increased (P=0.001) and decreased (P<0.001) thirty-day postoperative mortality, respectively (first meta-analysis). The pooled percentages for postoperative complications were 34.32% (95% CI: 24.59-44.75) (first meta-analysis) and 45.59% (95% CI: 35.62-55.74) (second metaanalysis). Higher percentages of squamous histology (P=0.001), lobectomy (P=0.002) and p-T1 or p-T2 (P=0.034) were associated with higher proportions of postoperative complications (second meta-analysis). The pooled threeand five-year survival probabilities were 68.25% (95% CI: 45.93-86.86) and 52.03% (95% CI: 34.71-69.11), respectively. Higher mean age (P=0.046) and percentage lobectomy (P=0.009) significantly reduced the five-year survival probability.Conclusions: Lobectomy and age were both accompanied by reduced five-year survival rate. Also, combined aorto-coronary bypass grafting (CABG) with lobectomy for squamous pT1 or pT2 LC displayed a higher risk of postoperative complications. Moreover, medical decision between combined or staged surgery is suggested to be individualized based on adequacy of coronary arterial perfusion, age, patient's preoperative performance status (taking into account possible co-morbidities per patient), tumor's staging and extent of lung resection.

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Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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“…[6][7][8][9][10][11] On the other hand the negative impact of COPD after pulmonary resec- The British Thoracic Society, in its guidelines on the selection of patients for lung cancer surgery, recommends that all patients should have equal access to lung cancer services regardless of age. 35 In a large retrospective study with 1073 patients, Takamochi et al reported that the rate of morbidity and mortality after pulmonary resection in elderly patients were similar to those observed in younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…5 It is generally accepted that elderly patients with non-small cell lung cancer (NSCLC) should not be excluded from curative resection only due to their chronological age as the operative results in this group are similar to that of younger patients. [6][7][8][9][10][11] The negative impact of COPD after pulmonary resections for NSCLC has been discussed in several studies, but the following question still remains to be answered: How fit are elderly patients with COPD for lobar lung resection?…”

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confidence: 99%

Lobar Lung Resection in Elderly Patients With Non-Small Cell Lung Carcinoma: Impact of Chronic Obstructive Pulmonary Disease on Surgical Outcome

Şenbaklavacı

2014

International Surgery

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The aim of this study was to evaluate the impact of chronic obstructive pulmonary disease (COPD) on the perioperative morbidity and mortality after lobar lung resection for non-small cell lung cancer (NSCLC) in patients aged 70 years and older. The medical records of 73 patients !70 years who underwent lobar lung resection for NSCLC from 2003 to 2013 at our department were reviewed retrospectively. There were 27 patients with a mean age of 73.6 years and mean predicted forced expiratory volume in 1 s (FEV1) of 69.7% in the COPD group whereas remaining 46 patients (mean age ¼ 75.6 years) in the non-COPD group had a mean predicted FEV1 of 79.1%. There were no significant differences in perioperative morbidity (4.8% in the COPD group versus 17.4% in the non-COPD group) between both groups. We had no perioperative mortality in both groups. Lobar lung resection for NSCLC seems to be a safe therapy option for elderly patients with COPD who are fulfilling the common functional criteria of operability so that radical surgery should remain the mainstay of treatment for early-stage NSCLC in this increasing subpopulation.

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Trends in Survival Based on Treatment Modality in Non-Small Cell Lung Cancer Patients: A Population-Based Study

Akhtar–Danesh

Akhtar-Danseh

Seow

et al. 2019

Cancer Investigation

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Lobar lung resection in elderly patients with non-small cell lung carcinoma: impact of cardiac comorbidity on surgical outcome

Cited by 3 publications

References 16 publications

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Lobar Lung Resection in Elderly Patients With Non-Small Cell Lung Carcinoma: Impact of Chronic Obstructive Pulmonary Disease on Surgical Outcome

Trends in Survival Based on Treatment Modality in Non-Small Cell Lung Cancer Patients: A Population-Based Study

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