Analysis of Risk Factors for Postpneumonectomy Bronchopleural Fistulas in Patients with Lung Cancer

Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

“…Asian patients provided 77.2% of the enrolled samples (11 510/14 912) (23,30,31,34,35,40,42,45,46,49,50), including 6923 cases from China (31,35), 4347 cases from Japan (23,30,34,40,42,49,50), 177 cases from Turkey (45) and 63 cases from Korea (46). The other 3402 patients (3402/14 912, ratio = 22.8%) were from European and North American countries and reported in 19 studies (21,22,(24)(25)(26)(27)(28)(29)32,33,(36)(37)(38)(39)41,43,44,47,48).…”

“…Twelve studies independently analyzed the effects of NC (21,26,34,35,37,38,42,(44)(45)(46)(47)50), another 11 studies analyzed the effects of neoadjuvant chemo-radiation (NCR) (24,(27)(28)(29)32,33,(39)(40)(41)44,49), and another four studies investigated the association between NR and BPF risk (23,46,48,50). Besides, the remaining studies (22,25,30,31,36,43) enrolled both NC cases and NR cases but analyzed them together, without providing any extractable detail on each strategy. The operations performed on lung cancer patients included pneumonectomy (21,22,25,26,(29)(30)(31)33,34,(36)(37)(38)(39)(40)...…”

“…Besides, the remaining studies (22,25,30,31,36,43) enrolled both NC cases and NR cases but analyzed them together, without providing any extractable detail on each strategy. The operations performed on lung cancer patients included pneumonectomy (21,22,25,26,(29)(30)(31)33,34,(36)(37)(38)(39)(40)(43)(44)(45)(46)(47)(48), lobectomy (32,42) and bronchoplasty (24,27,28,41). Four large-scale studies enrolled 9570 patients (9570/14 912, ratio = 64.2%) undergoing multiple types of resections but did not report the details of BPF occurrence in each operative mode (23,35,49,50).…”

“…Thirteen included studies (21,24,(26)(27)(28)(29)32,(37)(38)(39)41,44,45) analyzed the differences in BPF development between the patients undergoing NT followed by operations and those undergoing operations alone (NT + surgery vs. surgery alone) ( Table 2). The other 17 included studies (22,23,25,30,31,(33)(34)(35)(36)40,42,43,(46)(47)(48)(49)(50) classified 12 919 patients (12 919/14 912, ratio = 86.6%) by BPF occurrence, and evaluated the risk factors of BPF based on the patients with BPF and without BPF (BPF vs. non-BPF) ( Table 2). Furthermore, more than half of these 17 studies (22,23,30,31,35,40,42,43,47) performed both univariate analysis and multivariate analysis to comprehensively identify the independent factors of BPF.…”

“…The other 17 included studies (22,23,25,30,31,(33)(34)(35)(36)40,42,43,(46)(47)(48)(49)(50) classified 12 919 patients (12 919/14 912, ratio = 86.6%) by BPF occurrence, and evaluated the risk factors of BPF based on the patients with BPF and without BPF (BPF vs. non-BPF) ( Table 2). Furthermore, more than half of these 17 studies (22,23,30,31,35,40,42,43,47) performed both univariate analysis and multivariate analysis to comprehensively identify the independent factors of BPF. However, univariate analysis was generally used for the initially identification of some clinical parameters, and the subsequent multivariate analysis was conducted to further clarify their significances on serving as independent factors.…”