Modifiable risk factors for patients undergoing lung cancer surgery and their optimization: a review

Gagne, Sylvain; McIsaac, Daniel I.

doi:10.21037/jtd.2018.10.04

Cited by 19 publications

(15 citation statements)

References 113 publications

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“…Several studies agree that increase in risk of mortality with increased frailty is around twofold. [20][21][22] There are many plausible mechanisms for this that include reduced physiological reserve, which increases the risk of deterioration, and reduced cognitive function, which increases the risk of delirium. 23 Among the limited thoracic surgery-specific data, there is some suggestion that frailty may be even more strongly associated with adverse outcomes than in other specialties, with a four-to sevenfold increase in mortality risk reported, and therefore, risk models incorporating frailty scores have been developed, such as FORECAST (Frailty predicts death One year after Elective Cardiac Surgery Test); however, they need more thorough validation.…”

Section: Discussionmentioning

confidence: 99%

Elective Lung Resections in the Elderly: Where Do We Draw the Line?

Smelt

Lovejoy

Thakker

et al. 2020

Thorac Cardiovasc Surg

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Introduction The increasing longevity of the Western population means patients with a more advanced age are being diagnosed with resectable disease. With improvements in imaging and diagnostic capabilities, this trend is likely to develop further. As a unit operating on a higher proportion of older patients and with limited literature regarding the population of older than 85 years, we retrospectively compared the outcomes of patients older than 85 years in our unit treated with elective lung resection for non-small cell lung cancer (NSCLC) with those between the age of 80 and 84 years inclusive. Methods All patients who underwent elective lung cancer resection between the years 2012 and 2015 were identified from the National Thoracic Surgical Database. Results A total of 701 elective lung resections were performed during this time frame; 76 patients between the ages of 80 and 84 years and 18 patients older than 85 years. The follow-up period was 3 to 7 years. There was a significant increase in the Thoracic Surgery Scoring System (2.04; 2.96%, p = 0.0015) and a significant reduction in the transfer factor (94.7; 69.5%, p = 0.0001) between the younger and older groups. There were three (3.9%) in-hospital deaths in the 80 to 84 years age group and no in-hospital deaths in the 85 years and older age group. Conclusion This study demonstrates that surgery for early NSCLC can be safely performed in 85 years and older population. This is a higher risk population and parenchymal-sparing procedures should be considered.

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Section: Discussionmentioning

confidence: 99%

Elective Lung Resections in the Elderly: Where Do We Draw the Line?

Smelt

Lovejoy

Thakker

et al. 2020

Thorac Cardiovasc Surg

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“…We also had no data on pack-year smoking quantity or recent smoking cessation for study subjects, factors that might have differed by HIV status and have been associated with lung cancer surgery complications. [25]…”

Section: Discussionmentioning

confidence: 99%

Short-term outcomes for lung cancer resection surgery in HIV infection

Sigel

Stone

Wisnivesky

et al. 2019

Aids

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“…Furthermore, prohibitively small sample sizes prevent multivariable analyses from being performed in order to identify truly independent risk factors (31,32). Latterly, the importance of focussing on modifiable (in contrast to non-modifiable) risk factors has found favour as a potentially effective method of reducing the incidence of post-operative complications (33). The risk factors most commonly identified from multiple studies as strongly associated with PPCs include advanced age, poor pre-operative pulmonary functions tests, smoking status, cardiovascular comorbidities, chronic obstructive pulmonary disease and baseline functional status (24,31,32,34,35).…”

Section: Risk Factors For Ppcs After Thoracic Surgerymentioning

confidence: 99%

Aetiology, management and strategies for prevention of postoperative respiratory failure (PORF) after thoracic surgery

Taylor¹,

Charlesworth²,

Hayes³

et al. 2021

Shanghai Chest

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BackgroundLung cancer is the third most common cancer in the UK with over 47,000 new diagnoses each year. The National Cancer Registration and Analysis Service has quoted that the proportion of patients with non-small cell lung cancer (NSCLC) undergoing surgery each year in the UK was approximately 16% between 2013 and 2015, which represents a marked increase from the 8.8% and 10.6% quoted for 1998 and 2008 respectively (1). Following surgery for lung cancer, the 30-day mortality rate is approximately 2%, and rises to around 5% at 90 days. Oneyear survival after lung cancer surgery is around 88% (2).Reduction of mortality and morbidity after lung cancer surgery is as an important component of improving lung cancer survival. This is because most patients undergoing surgery are early stage (stage I and II) lung cancer patients. Hence, if survival in this group of patients can be optimised, it is likely to have a significant (and disproportionate) impact on overall lung cancer survival rates, because if these patients survive the perioperative period they are much more likely to survive to five years and beyond as compared with patients with more advanced lung cancer. Complications after thoracic surgeryDevelopment of post-operative complications is associated with poor patient satisfaction (3), prolonged critical care and overall hospital stay, increased healthcare costs and increased mortality. Post-operative complications after thoracic surgery occur in around 15-40% of patients (4). Moreover, the incidence of even a single post-operative complication can lead to additional adverse outcomes (5). Studies looking to reduce rates of complications in this patient group have identified several risk factors associated with complications after thoracic surgery. Interventions aimed at modifying these risk factors could therefore logically lead to better outcomes and improved survival

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Modifiable risk factors for patients undergoing lung cancer surgery and their optimization: a review

Cited by 19 publications

References 113 publications

Elective Lung Resections in the Elderly: Where Do We Draw the Line?

Elective Lung Resections in the Elderly: Where Do We Draw the Line?

Short-term outcomes for lung cancer resection surgery in HIV infection

Aetiology, management and strategies for prevention of postoperative respiratory failure (PORF) after thoracic surgery

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