Background: Afatinib, an irreversible ErbB family blocker, significantly improved progression-free survival (PFS) versus platinum-doublet chemotherapy as first-
A presumptive diagnosis of IP or an IP pattern on computed tomography (CT) was confirmed histologically by examination of resected specimens and/or the presence of the clinical diagnostic criteria. Acute exacerbation of IP was defined according to the guidelines of the Japanese Respiratory Society when the following criteria were fulfilled within 1 month: (1) increased respiratory distress; (2) fibrosis, newly developed ground glass opacity and infiltrative shadow on high-resolution computed tomography (HRCT); and (3) >10 Torr decrease in PaO 2 under the same oxygenation conditions. (4) no evidence of pulmonary infection, heart failure, pneumothorax, and pulmonary embolism. We studied the following clinicopathologic features in patients with lung cancer associated with IP: gender, age, surgical methods, pathologic stages, mortality rate, and post-operative complications, including acute exacerbation of IP. Result: Fifty-three patients underwent surgery. The mean age was 70.8 years (50 males and 3 females). Forty-three, 1, and 9 patients underwent lobectomies, a segmentectomy, and partial resections, respectively. Twenty-three, 17, and 13 patients were stage I, II, and III, respectively. Eight patients had postoperative acute exacerbations of IP and there were three in-hospital deaths caused by acute exacerbations. Of note, there have been no inhospital deaths since 2013. Conclusion: It is possible to prevent severe post-operative complications in patients with lung cancer associated with IP with the aid of intra-operatively and optimal peri-operative management.
Background: Radical surgical resection of lung cancer with or without adjuvant treatment is still a prerequisite for cure. Advances in operative and postoperative care led to a decline in complications and mortality rates during the last decades. In spite of different additional modes of treatment, survival is still poor. Methods: We analyzed 968 patients who underwent lung resection for bronchial carcinoma, with non-small cell lung cancer during a 12-year period (January 2004-December 2017). Postoperative events studied were divided into major and minor complications or death during the first 30 days after surgery. Results: Of 968 patient, 690 (70.5%) were male and 278 (28.7%) female. Mean age 65.5 ± 9.4 years (range: 15-87 years). Lobectomy was the most used surgical modality in 566 (58.5%) patients, meanwhile pneumonectomy was performed in 112 (11.6%) of patients. Minor complications during surgery occurred in 45 (11.7%) of patients. Continuous air leakage was the most complication after surgery in 25.3%, followed by lung atelectasis in 21.3% and cardiovascular complications in 17%. Of the life threatening complications respiratory failure was the most events in 20.0% of patients, followed by broncho-pleural fistula in 18.7% and pulmonary edema in 15% of patients. The 30-day mortality rate was 3.8% (37) patients, 1.2% after single lobectomy and 13.4 % after pneumonectomy. Conclusion: Our results show low mortality and morbidity after lung cancer surgery. However, patients with reduced lung capacity, older age and those undergoing pneumonectomy should be treated with great care.
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