Comprehensive study of prognostic risk factors of patients underwent pneumonectomy

Abstract

Introduction: To investigate postoperative complications and the prognostic risk factors of patients underwent pneumonectomy. Methods: Four hundred and six patients underwent pneumonectomy were subjected to the study. All the clinicopathologic data including age, gender, smoking history, surgical treatment, postoperative complications, tumor staging and the follow-up information were investigated. Results: The 30-day and 90-day mortality rates were 3.2% and 6.2%, respectively. Postoperative complications developed in 149 patients (36.7%), mainly included arrhythmia, transfusion, pulmonary infection, bronchopleural fistula and acute respiratory distress syndrome. During the follow-up, 189 patients experienced a relapse, consisting of 51 patients with local recurrence and 138 with distant recurrence. The median survival time was 24.4 months and the overall 1-year, 3-year and 5-year survival rates were 82.7%, 50.9% and 32.5%, respectively. Moreover, the overall 1-year, 3-year, 5-year survival rates for patients with non-small cell lung cancer (NSCLC) were 84.1%, 52.1% and 32.5%, respectively and patients with small cell lung cancer (SCLC) were 56.1%, 38.5% and 28.8%, respectively. Among NSCLCs, adenocarcinomas had a worse prognosis than squamous carcinomas. Compared to right pneumonectomy, patients with left pneumonectomy had a better prognosis. Multivariable analysis revealed ICU stay, disease stage, nodal stage and adjuvant chemotherapy were all significant predictors of overall survival (OS). Conclusions: Pneumonectomy is still a valuable and effective treatment option for patients with advanced lung cancer. Surgeons should be more cautious when patients had higher disease stage, adenocarcinoma and right-side lung cancer. Neoadjuvant chemotherapy did not affect the prognosis. Pneumonectomy could also achieve acceptable survival outcomes in well-selected SCLC patients.

RNA m6A Modification in Cancers: Molecular Mechanisms and Potential Clinical Applications

“…Lung cancer is the leading cause of cancer-related mortality worldwide. [77][78][79][80][81][82][83] METTL3 is the oncogene of lung cancer through different mechanisms. Lin et al 84 found that METTL3 can enhance RNA translation without the aid of methyltransferase and reader protein activity.…”

Trends in pneumonectomy for treatment of small-cell lung cancer

“…Since early publications decades ago in which nearly 77% of patients with SCLC underwent pneumonectomy, 20 the use of pneumonectomy as a surgical option for SCLC has declined steadily, with recent reports of only 5% or less in the last 5 years (Appendix C). 9…”

“…Pneumonectomy is considered to be a high-risk procedure associated with higher morbidity and mortality relative to other surgical resection options. 9 Several modern studies have reported mortality of 3% to 5.8% after a standard pneumonectomy. 10 , 11 Therefore, the objective of this study was to determine overall survival associated with SCLC patients who underwent pneumonectomy as part of their primary treatment, and to characterize the current trends in pneumonectomy for SCLC.…”

On the Application of Combine Soft Set with Near Set in Predicting the Lung Cancer Mortality Risk

“…Numerous factors are influencing the complication and mortality of malignant disease after pneumonectomy [26]. In [27] the author Analyzed the health history of 406 successive patients who experienced pneumonia to detect postoperative signs and risk factors affecting long-term survival. In [28] the author Discuss postoperative mortality in patients who have undergone pneumonectomy with vascular disease and find that they are significantly elevated.…”