Association of body mass index and outcomes following lobectomy for non-small-cell lung cancer

Wang, Cui; Guo, Min; Zhang, Nan; Wang, Gongchao

doi:10.1186/s12957-018-1394-6

Cited by 23 publications

(25 citation statements)

References 23 publications

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“…The length of stay of our patients in hospital after surgery for lung cancer was similar in obese and nonobese patients. This is in accordance with a recent study of lung cancer obese and nonobese patients who underwent lobectomy (Wang et al, 2018). However, the length of stay of the patients with severe pain early in the postoperative period (who also had higher BMI) was significantly longer than the patients who suffered less in the postgeneral anesthesia room.…”

Section: Discussionsupporting

confidence: 93%

Increased Pain Sensitivity in Obese Patients After Lung Cancer Surgery

et al. 2019

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Background: Obesity and cancer are recognized worldwide health threats. While there is no reported causal relationship, the increasing frequency of both conditions results in a higher incidence of obese patients who are being treated for cancer. Physiological data indicate that there is a relationship between obesity and susceptibility to pain; however, currently, there are no specific pharmacological interventions. Objective: To evaluate the self-reported intensity of postoperative pain in obese and nonobese lung cancer who receive either thoracotomy or video-assisted thoracic surgery (VATS) surgical therapy. Material and Methods: In 50 obese [mean body mass index (BMI) of 34.1 ± 3.2 kg/m 2 ] and 62 nonobese (mean BMI of 24.9 ± 3 kg/m 2 ) lung cancer patients, the intensity of pain was estimated every 4 h using a visual analog scale (VAS, 0 indicating no pain and 10 indicating “worst imaginable pain”) beginning shortly after surgery (Day O) and continuing until the day of discharge (Day D). Results: The self-reported pain was more severe in obese than in nonobese patients, both at the time of the operation [Day O (4.5 ± 1.2 vs 3.4 ± 1.1; p < 0.0001)] and at the day of discharge [Day D (3.9 ± 1.4 vs 2.6 ± 0.9, p < 0.0001)]. This finding was consistent both in the patients after thoracotomy and after video-assisted thoracic surgery (VATS, p < 0.0001). The patients with severe pain shortly after surgery (VAS score >4) had significantly higher BMI (31.8 ± 5.6 kg/m 2 vs 28.8 ± 5.2 kg/m 2 , p < 0.01) and were hospitalized longer than the remaining patients (13.0 ± 13.6 days vs 9.5 ± 3.6 days, p < 0.05). Conclusion: The reported perception of pain in obese lung cancer patients is greater than in nonobese patients undergoing the same thoracic surgery. In obese patients, severe pain persisted longer. Pain management is an important consideration in the postoperative care of lung cancer patients, even more so with obese patients.

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Section: Discussionsupporting

confidence: 93%

Increased Pain Sensitivity in Obese Patients After Lung Cancer Surgery

et al. 2019

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“…Additionally, an elevated BMI in patients will lead to increased difficulty during surgery and prolonged operative times 16. The prevalence of overweight and obesity is showing an upward trend 17. Thoracic surgeons will encounter more overweight and obese lung cancer patients in the future.…”

Section: Discussionmentioning

confidence: 99%

<p>Risk factors of postoperative pulmonary complications after minimally invasive anatomic resection for lung cancer</p>

Yang¹,

Wu²,

Yao³

et al. 2019

TCRM

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PurposeThis study investigated the perioperative risk factors of postoperative pulmonary complications (PPCs) after minimally invasive anatomic resection for lung cancer.Patients and methodsWe retrospectively reviewed the data from medical records of 729 lung cancer patients undergoing minimally invasive anatomic lung resections between January 2017 and December 2017. Univariate and binary logistic regression analyses were performed to select the independent risk factors for PPCs during the patient’s postoperative hospitalization after surgery.ResultsThe incidence of PPCs was 24.8% (n=181/729). No patient died during the period of hospitalization. Logistic regression analysis revealed that body mass index (BMI) ≥24.0 kg/m2 (vs <24.0 kg/m2: OR 1.514, 95% CI 1.057–2.167, P=0.024), single segmentectomy (vs single lobectomy: OR 2.115, 95% CI 1.150–3.891, P=0.016), bilobectomy or combined lobectomy and segmentectomy (vs single lobectomy: OR 2.731, 95% CI 1.013–7.361, P=0.047), and right lung lobe surgery (vs left lung lobe surgery: OR 1.519, 95% CI 1.046–2.205, P=0.028) were independent risk factors for PPCs in lung cancer patients who received minimally invasive anatomic lung resections.ConclusionIndividual factors such as BMI ≥24.0 kg/m2, single segmentectomy, bilobectomy or combined lobectomy and segmentectomy, and right lung lobe surgery were independent risk factors of PPCs, which should be helpful for risk stratification, patient counseling, and perioperative care for lung cancer patients.

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“…Measurements of body mass index (BMI) and serum albumin as classic indicators of nutritional status and have been previously studied as potential indicators of prognosis in patients with cancer [5,6]. Recently, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been described as a prognostic factor in patients with several types of malignant tumors, including in gastrointestinal cancer [7], and genitourinary cancer [8].…”

Section: Introductionmentioning

confidence: 99%

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score in Patients with Small Cell Lung Cancer Before First-Line Treatment with Etoposide and Progression-Free Survival

et al. 2019

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Background The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic factor in patients who have some types of malignant tumors. The aim of this study was to investigate the prognostic significance of the HALP score in patients with small cell lung cancer (SCLC) before first-line treatment with etoposide. Material/Methods A retrospective study included 178 patients with SCLC who received first-line chemotherapy with etoposide between September 2015 and May 2019. The baseline clinical characteristics and blood parameters were recorded. Univariate and multivariate analysis and Kaplan-Meier plots were used to identify the factors associated with progression-free survival (PFS). Results The optimal cut-off values of the HALP score was determined by X-tile software to be 25.8. Univariate and multivariate analysis showed that in 178 patients, the HALP score, body mass index (BMI), and serum albumin levels had no prognostic significance. In the patient age group <65 years, a BMI ≥24 kg/m 2 was an independent prognostic factor (HR, 1.943; 95% CI, 1.251–3.018) (P=0.003). In the patient age group ≥65 years, a HALP score >25.8 was an independent positive prognostic factor for outcome following first-line treatment with etoposide (HR, 0.483; 95% CI, 0.270–0.865) (P=0.014). Conclusions In patients <65 years with SCLC who underwent first-line treatment with etoposide, a BMI ≥24 kg/m 2 an independent prognostic factor, and in patients ≥65 years, a HALP score >25.8 was an independent predictor of improved outcome, associated with increased PFS.

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Association of body mass index and outcomes following lobectomy for non-small-cell lung cancer

Cited by 23 publications

References 23 publications

Increased Pain Sensitivity in Obese Patients After Lung Cancer Surgery

Increased Pain Sensitivity in Obese Patients After Lung Cancer Surgery

<p>Risk factors of postoperative pulmonary complications after minimally invasive anatomic resection for lung cancer</p>

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score in Patients with Small Cell Lung Cancer Before First-Line Treatment with Etoposide and Progression-Free Survival

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