Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer.

Pastorino, Ugo; Valente, Maurizio; Bedini, Vittorio; Pagnoni, Annamaria; Ravasi, Gianni

doi:10.1136/thx.37.9.680

Cited by 20 publications

(10 citation statements)

References 5 publications

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“…In 278 tumours, identification of the pathological stage (exploratory thoracotomy, poor nodal classification) was not possible. The distribution per stages of the remaining 2716 cases was as follows: hidden stage or 'in situ ' 6,IA 290,IB 997,IIA 43,IIB 401,IIIA 524,IIIB 413,IV 42. In 2928 cases (98%), primary data on FEV1 and FVC were available and, thus, the FEV1/FVC relation known; of these 2928 cases, 1370 patients (46%) had COPD. The FEV1% values were: mean 70.6 (SD 16.2); median 70.6.…”

Section: Resultsmentioning

confidence: 99%

“…Other prognostic studies on this specific comorbidity (COPD) have also shown its prognostic value to determine overall survival [6] and the mortality caused by other late intercurrent conditions after 3 years of follow-up [7].…”

Section: Discussionmentioning

confidence: 99%

“…Comorbidity as a possible independent prognostic factor in surgically treated LC (SLC) [6][7][8][9] has not been analysed as frequently.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer

López-Encuentra

Astudillo

Cerezal

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer

López-Encuentra

Astudillo

Cerezal

et al. 2005

European Journal of Cardio-Thoracic Surgery

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“…In a recent randomized clinical study, systematic nodal dissection was found to significantly influence survival in every stage of resectable NSCLC (17). Thirdly, lung cancer patients frequently suffer from comorbidities, including chronic obstructive pulmonary disease and cardiovascular diseases, which were found to significantly affect survival (18,19). Additionally, an imbalance in the proportion of patients who quit smoking after radical surgery may potentially account for survival differences as shown in a study of 273 pathologic stage I NSCLC patients where the amount of smoking exposure was found to be a highly significant predictor of overall survival (20).…”

Section: Discussionmentioning

confidence: 99%

The ALPI Trial: The Italian/European Experience with Adjuvant Chemotherapy in Resectable Non–Small Lung Cancer

Scagliotti

2005

Clinical Cancer Research

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Postoperative treatments for lung cancer have been evaluated for more than two decades, but in the majority of the studies no significant and clinically meaningful effect on survival has been shown. In 1995, a meta-analysis of eight cisplatin-based adjuvant chemotherapy trials in 1,394 patients with non^small cell lung cancer showed a 13% reduction in the risk of death (P = 0.08). The nonstatistically significant benefit reported in the meta-analysis prompted the planning of several randomized studies of platinum-based chemotherapy. Three studies addressed the issue of adjuvant chemotherapy in all the resected stages of non^small cell lung cancer (I-IIIA): the Italian/European study Adjuvant Lung Cancer Project Italy, the International Adjuvant Lung Cancer study, and the British Big Lung Trial. In contrast to the International Adjuvant Lung Cancer, the Adjuvant Lung Cancer Project Italy and the underpowered British Big Lung Trial failed to prospectively confirm a significant role of adjuvant chemotherapy in completely resected non^small cell lung cancer. In this article, we will discuss the findings of the Adjuvant Lung Cancer Project Italy study in the context of the International Adjuvant Lung Cancer and British Big Lung Trial.Lung cancer remains the most common fatal malignancy among men and women in Europe (1) and worldwide (2). In nonsmall cell lung cancer (NSCLC), which represents >80% of all newly diagnosed cases of lung cancer, the main curative therapeutic approach for early disease (stage IA-IIB) is surgery. Unfortunately, these cases represent only a minority (20-25%) of all cases of NSCLC. The rationale for use of systemic therapy in completely resected NSCLC is based on follow-up studies after radical resection that have shown the predominance of distant failures over local recurrences and on clinical and pathologic evidence of early microdissemination of the disease at the time of surgery. Long-term survival in NSCLC following surgical resection is stage related, but even in stage IA one-third of patients will relapse and die of their disease within 5 years (3, 4).Postoperative treatments, including chemotherapy, radiotherapy, or both, have been evaluated for more than two decades, and in the vast majority of the studies, no significant and clinically meaningful effect on survival has been shown. In 1995, a meta-analysis done in different subgroups of NSCLC patients receiving chemotherapy overviewed eight cisplatin-based adjuvant chemotherapy trials in 1,394 patients and found a 13% reduction in the risk of death, which was close to the borderline of statistical significance (P = 0.08). Similarly, there was a 6% reduction in the risk of death in patients treated with postoperative cisplatin-based chemotherapy compared with patients who received only postoperative radiotherapy (P = 0.46). On the other hand, adjuvant chemotherapy with long-term alkylating agents was significantly detrimental (5).These findings failed to have an effect on clinical practice, not because the absolute gain was t...

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“…Cardiovascular diseases increase the risk of death after lung resection surgery by up to 5-fold 35 and that of major complications by up to 12-fold. 36 Diabetes increases the risk of lung infections in general and of developing one after lung resection in particular.…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Respiratory Infections After Lung Cancer Resection

Belda

Cavalcanti

Iglesias

et al. 2006

Clinical Pulmonary Medicine

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The progress that has been made in patient selection, minimally invasive surgery, anesthesia (both in surgery and in the control of postoperative pain), and antibiotic treatments have substantially improved the morbility and mortality associated with the surgical treatment of bronchogenic carcinoma in recent years. Nevertheless, the rate of major complications after lung cancer resection is 2% to 22%, and the mortality rate is 2% to 7%. The most frequent complications after lung cancer resection are of respiratory origin. The most serious ones are pneumonia and acute respiratory distress syndrome, and they are also the main causes of death in this period. They also share similar clinical and evolutionary features that can make it difficult to distinguish between them. The incidence of pneumonia after a lung cancer resection is 2% to 20%, and the mortality in patients that develop pneumonia is significantly higher than in other patients. It is also the cause of death in 22% to 67% of cases after lung resection. Therefore, patients with lung cancer treated with lung resection comprise a population with a high risk of experiencing pneumonia with a serious prognosis. Apart from being one of the main factors that determine short-term survival, postoperative pneumonia prolongs the hospital stay and involves a significant consumption of resources (antibiotics, stay in intensive care unit). For all these reasons, there is growing interest in identifying the factors associated with the risk, prevention, diagnosis, and treatment of respiratory infections after lung cancer resection.Key Words: lung cancer resection, postoperative pneumonia, risk factors (Clin Pulm Med 2006;13: 8 -16) B ronchogenic carcinoma is the most frequent neoplasia (900,000 new cases in men and 330,000 in women per year) and the first cause of death from cancer in the world in both men and women. 1 The overall probability of being alive 5 years after the diagnosis is 15%, a percentage that has barely changed in the last 35 years. 2 This is the result of, among other reasons, diagnosis in the advanced stages of the disease (less than 30% of cases are diagnosed in stages I and II, when the disease is limited and surgical resection offers a probability of survival at 5 years of 70% and 40%, respectively). Early diagnosis is therefore decisive to take advantage of surgical treatment, which is the option that currently offers the greatest probability of a cure to the greatest number of patients (Table 1).The advances made in anesthesia and minimally invasive surgery have allowed surgical indications to be extended to those patients who are at greater risk of experiencing complications or dying after a lung resection. Moreover, multidisciplinary treatments of bronchogenic carcinoma have led to more pneumonectomies, with a subsequent increase in the morbidity and mortality associated with resection. Reducing the complications and mortality associated with the surgical treatment of bronchogenic carcinoma is another important aspect if the potential benefit...

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Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer.

Cited by 20 publications

References 5 publications

Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer

Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer

The ALPI Trial: The Italian/European Experience with Adjuvant Chemotherapy in Resectable Non–Small Lung Cancer

Respiratory Infections After Lung Cancer Resection

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