The probability of having died of lung cancer continued to increase beyond 5 years after the operation. Surveillance of risk factors associated with an increased mortality rate should be considered in the postoperative follow-up examination after lung cancer resection.
Background: Lung cancer is the leading cause of cancer death worldwide. The incidence and mortality rate of lung cancer in women has increased. Studies have indicated that females with non-small cell lung cancer (NSCLC) have better survival than males. We aimed to examine the impact of gender on 1-, 5-and 10-year survival after surgery for stage I and II NSCLC. Materials and methods: During the period 2003-2013, 692 patients operated for stage I and II NSCLC were prospectively registered. Patients were stratified into four groups according to gender and age over or less than 66 years. The relationship between gender and age on overall survival was investigated. Adjustment for multiple confounders was performed using the Cox proportional hazard regression model. Results: Surgical resection was performed in 368 (53.2%) males and 324 (46.8%) females. During the study period, mortality was 35.2% in younger females, 34.9% in younger males, 42.8% in older females and 51.2% in older males. Stratified by age, there were no significant gender differences with regard to survival [hazard ratio (HR) 1.16, 95% confidence interval (CI) 0.91-1.46, p ¼ .23]. Comparing the younger and the older patients adjusted for confounders, the mortality risk was significantly increased in elderly patients [females, adjusted HR 1.60, 95% CI 1.12-2.28]. Compared with population data, standardized mortality ratio was increased to 4.1 (95% CI 3.5-4.7) in males and to 6.5 (95% CI 5.4-7.6) in females. Conclusion: Overall survival did not differ significantly between males and females. Adjusted for confounding factors, we found a significantly increased mortality risk in elder patients compared to their younger counterparts. However, five-year overall survival of more than 50% for older patients with NSCLC should encourage surgical treatment also in elderly lung cancer patients.
Lung autotransplantation can be a surgical alternative to gain access to the posterior mediastinum and the thoracic portion of the descending aorta through a sternotomy. We present a case of hemoptysis and bronchial obstruction due to a presumed infected aortobronchial fistula, secondary to stent graft placement in a patient with multiple previous surgeries for aortic coarctation, treated with lung autotransplantation and an extra‐anatomic bypass.
A man in his 40s was admitted to his local hospital 6 days after the first vague symptoms of COVID-19. His general condition deteriorated, and he was treated in the intensive care unit but did not require mechanical ventilation. During his recovery, he experienced a cough spell, after which his dyspnoea recurred and rapidly increased. CT pulmonary angiogram showed a 10×18 cm cavitary lesion with an air-fluid level and surrounding atelectasis of the right lower lobe. A one-way valve mechanism had developed, leading to the formation of a pneumatocele. The patient was treated by occlusion of all bronchial segments of the right lower lobe with endobronchial valves, and the pneumatocele was evacuated with a pigtail catheter. The valves were removed 4 weeks after insertion, and the right lower lobe re-expanded. Six months after treatment, the patient had recovered completely and almost regained his former lung function.
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