Does obesity affect the outcomes of pulmonary resections for lung cancer? A National Surgical Quality Improvement Program analysis

Mungo, Benedetto; Zogg, Cheryl K.; Hooker, Craig M.; Yang, Stephen C.; Battafarano, Richard J.; Brock, Malcolm V.; Molena, Daniela

doi:10.1016/j.surg.2014.10.016

Cited by 31 publications

(20 citation statements)

References 25 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, BMI, age and ASA score were not significant risk factors for the development of PPCs in our study. Other investigators have found that obesity does not confer greater morbidity and mortality after lung resection 33. We have shown that age is not a predictive factor for development of a PPC.…”

Section: Discussioncontrasting

confidence: 52%

Long-term impact of developing a postoperative pulmonary complication after lung surgery

Lugg

Agostini

Tikka

et al. 2016

Thorax

152

133

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 52%

Long-term impact of developing a postoperative pulmonary complication after lung surgery

Lugg

Agostini

Tikka

et al. 2016

Thorax

152

133

View full text Add to dashboard Cite

show abstract

“…In one study using National Surgical Quality Improvement Program database, high BMI did not negatively influence 30-day perioperative mortality, hospital length of stay, or perioperative complications after pulmonary resections. 2 A similar study of 1369 patients treated surgically for lung cancer at a single institution also demonstrated similar perioperative outcomes despite varied range of BMIs. 3 …”

Section: Introductionmentioning

confidence: 74%

The Influence of Body Mass Index on Overall Survival Following Surgical Resection of Non–Small Cell Lung Cancer

Sepesi

Gold

Correa

et al. 2017

Journal of Thoracic Oncology

View full text Add to dashboard Cite

Background Population studies suggest that high body mass index (BMI) correlates with a reduced risk of death from lung cancer. The aim of our study was to evaluate definitively the influence of BMI on long term overall survival (OS) in surgical patients with non-small cell lung cancer (NSCLC). Methods Study population consisted of 1935 patients who underwent surgical resection for lung cancer at MD Anderson Cancer Center (2000-2014). Study variables included both patient and treatment related characteristics. Univariate and multivariate Cox regression analyses were performed to identify variables associated with overall survival. Results On univariate analysis, significant predictors of improved survival were higher BMI, pathologic tumor stage (stage I vs II, III, or IV), type of surgery (lobectomy/pneumonectomy versus wedge resection/segmentectomy), younger age, female gender, and adenocarcinoma histology (versus squamous) (all p<0.05, Table 2 and 3). Morbidly obese patients (BMI≥35) had a trend towards better outcomes than those classified as obese (BMI ≥30 and <35) (p=0.05), overweight (BMI ≥25 and <30) (p=0.13), or healthy weight (BMI <25) (p=0.37) (HR 0.727, 0.848, 0.926, and 1, respectively). On multivariate analysis, BMI remained an independent predictor of survival (p=0.02). Propensity matching analysis demonstrated significantly better OS (p=0.003) in patients with BMI≥30 as compared to BMI 25. Conclusions In this large, retrospective, single center series, after controlling for disease stage and other variables, higher BMI was associated with improved OS following surgical resection of NSCLC. Further studies are necessary to elucidate the precise relationship between BMI and treatment outcomes.

show abstract

“…Other investigators have found that the prevalence of low and normal BMI was greater among patients who are active smokers; those underweight patients had a greater risk-adjusted LOS compared to normal weight patients [15]. We have previously investigated the risk factors for developing a PPC, and although lower preoperative FEV 1 % predicted and COPD diagnosis are associated with PPC on univariate analysis, only COPD diagnosis is regarded as an independent risk factor for PPC development or multivariate analysis [1, 2].…”

Section: Discussionmentioning

confidence: 99%

Smoking and timing of cessation on postoperative pulmonary complications after curative-intent lung cancer surgery

Lugg

Tikka

Agostini

et al. 2017

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundSmoking is a risk factor for postoperative pulmonary complications (PPC) following non-small cell lung cancer (NSCLC) surgery. The optimal timing for preoperative smoking cessation has not been identified. Our study aimed to observe the impact of preoperative smoking cessation on PPC incidence and other postoperative outcomes including long-term survival.MethodsA prospective study included consecutive patients following resection for NSCLC in a regional thoracic centre over a 4-year period (2010–2014). Patients were stratified according to self-reported preoperative smoking status. The primary endpoint was PPC incidence, which was assessed from postoperative day one onwards using the Melbourne Group Scale. Secondary endpoints included short-term outcomes (hospital length of stay [LOS], intensive therapy unit [ITU] admission, 30-day hospital readmission rate) and long-term survival.ResultsFour hundred and sixty-two patients included 111 (24%) current smokers, 55 (12%) ex-smokers <6 weeks, 245 (53%) ex-smokers ≥6 weeks and 51 (11%) never smokers. PPC occurred in 60 (13%) patients in total. Compared to never smokers, current smokers had a higher frequency of PPC (22% vs. 2%, p = 0.004), higher frequency of ITU admission (14% vs. 0%; p = 0.001) and a longer median (IQR) hospital LOS (6 [5] vs. 5 [2]; p = 0.001). In the ex-smokers there was a trend for a lower frequency of PPC (<6 weeks, 10.9% vs. ≥6 weeks, 11.8%) and ITU admission (<6 weeks, 5.5% vs. ≥6 weeks, 4.5%), but there was no difference between the <6 weeks or ≥6 weeks ex-smoking groups prior to surgery. There was no significant difference in long-term survival found between the groups of differing smoking status (median follow-up 29.8 months, 95%CI 28.4–31.1).ConclusionCurrent smokers have higher postoperative morbidity; this risk reduces following smoking cessation but 6 weeks does not appear to identify a time-point where differences in outcomes are noted.

show abstract

Does obesity affect the outcomes of pulmonary resections for lung cancer? A National Surgical Quality Improvement Program analysis

Cited by 31 publications

References 25 publications

Long-term impact of developing a postoperative pulmonary complication after lung surgery

Long-term impact of developing a postoperative pulmonary complication after lung surgery

The Influence of Body Mass Index on Overall Survival Following Surgical Resection of Non–Small Cell Lung Cancer

Smoking and timing of cessation on postoperative pulmonary complications after curative-intent lung cancer surgery

Contact Info

Product

Resources

About