Pneumonectomy for lung cancer: Contemporary national early morbidity and mortality outcomes

Thomas, Philippe; Berbis, Julie; Baste, Jean-Marc; Pimpec‐Barthes, Françoise Le; Tronc, François; Falcoz, Pierre‐Emmanuel; Dahan, M.; Loundou, Anderson

doi:10.1016/j.jtcvs.2014.09.063

Cited by 89 publications

(72 citation statements)

References 28 publications

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“…Recently, there is growing evidence suggesting that neoadjuvant treatment is not related to higher morbidity and mortality. [8,9] Our results also showed that factors such as right pneumonectomy, neoadjuvant therapy, smoking, and extended resection, which were previously related to postoperative morbidity, were not found to significantly increase non-malignancy-related long-term respiratory morbidity.…”

Section: Discussionsupporting

confidence: 59%

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Risk factors for malignancy-unrelated long-term respiratory events after pneumonectomy

Aydoğmuş¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada pnömonektomi sonrası geç başlangıçlı maligniteden bağımsız solunum olayları değerlendirildi.Ça lış mapla nı:Ocak 2009 -Eylül 2014 tarihleri arasında kliniğimizde pnömonektomi geçirmiş 78 hastanın (73 erkek, 5 kadın; ort. yaş 55.6±9.6 yıl; dağılım 32-79 yıl) tıbbi verileri retrospektif olarak incelendi. Ameliyat öncesinde sigara içme alışkanlıkları, eşlik eden hastalıklar, Amerikan Anesteziyoloji Derneği risk skoru, EuroSCORE, neoadjuvan kemoterapi ihtiyacı, kanser hücre tipi ve klinik evre kaydedildi. Ameliyat sonrasında komplikasyonlar ve uygulanan tedavi yöntemlerine ilişkin veriler kaydedildi. Bul gu lar:Ortalama takip süresi 35.2±22.0 ay (dağılım 9-104 ay) idi. Hastaların 21'inde (%35.0) lokal nüks ve ikinci primer akciğer tümörü gibi malignite ile ilişkili solunum olayı gelişti. Malignite ile ilişkisiz solunum olayları 18 hastada (%31.6) görüldü. Amerikan Anesteziyoloji Derneği skoru yüksek olan (p= 0.01), ameliyat öncesi birinci saniyedeki zorlu ekspiratuvar volüm <%60 olan (p= 0.05) ve EuroSCORE'u yüksek olan (p= 0.04) hastalarda uzun dönem, malignite ile ilişkisiz morbidite daha yaygın idi. Çok değişkenli analizde, Amerikan Anesteziyoloji Derneği skoru yüksek olan (p= 0.01) ve ameliyat öncesi birinci saniyedeki zorlu ekspiratuvar volüm <%60 olan (p= 0.03) hastalarda malignite ile ilişkisiz solunum olayları istatistiksel olarak anlamlı düzeyde daha sık idi.So nuç:Çalışma sonuçlarımız pnömonektomi yapılan hastalarda hem kısa dönem hem de uzun dönem solunum morbiditelerinin gelişebileceğini ve Amerikan Anesteziyoloji Derneği skoru yüksek olan ve ameliyat öncesi birinci saniyedeki zorlu ekspiratuvar volümü düşük olan hastalarda malignite ile ilişkisiz morbidite riskinin artmış olduğunu göstermektedir.Anah tarsöz cük ler: Kanser; uzun dönem bakım; akciğer; pnömonektomi. ABSTRACTBackground:In this study, we aimed to evaluate late-onset, malignancyunrelated respiratory events following pneumonectomy.

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Section: Discussionsupporting

confidence: 59%

“…[1,4,7,9] However, the long-term implications of these risk factors are not well-known. Long-term survival after pneumonectomy is primarily associated with the stage of lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for malignancy-unrelated long-term respiratory events after pneumonectomy

Aydoğmuş¹

2017

Turk Gogus Kalp Dama

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“…In that study current cigarette smoking was much more frequent in the underweight category (44.7% vs. 20.9% among obese patients). In another study of 4498 LC patients, any pulmonary complications following pneumonectomy tended to be more frequent in both underweight and obese patients [7], suggesting a U-shaped relationship with POP.…”

Section: Discussionmentioning

confidence: 93%

Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival

Simonsen

Søgaard

Bozi

et al. 2015

Respiratory Medicine

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“…[6] In this regard, findings from the NCDB are congruent with previous reports. [28,29] In the European Organization for Research and Treatment of Cancer (EORTC) trial for surgery in Stage IIIA-N2 NSCLC following induction therapy, approximately one half of patients in the surgical arm received a pneumonectomy. [7] This is disproportionate compared to the NCDB where 13% of stage IIIA patients underwent a pneumonectomy.…”

Section: Commentmentioning

confidence: 99%

The Role of Surgical Resection in Stage IIIA Non-Small Cell Lung Cancer: A Decision and Cost-Effectiveness Analysis

Samson

Patel

Robinson

et al. 2015

The Annals of Thoracic Surgery

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Purpose To evaluate the cost-effectiveness of combination chemotherapy, radiation, and surgery (CRS) versus definitive chemotherapy and radiation (CR) in clinical Stage IIIA non-small cell lung cancer (NSCLC) patients at academic and non-academic centers. Methods Patients with clinical stage IIIA NSCLC receiving CR or CRS from 1998–2010 were identified in the National Cancer Data Base (NCDB). Propensity score matching on patient, tumor, and treatment characteristics was performed. Medicare allowable charges were used for treatment costs. The incremental cost effectiveness ratio (ICER) was based on probabilistic 5-year survival and calculated as cost per life year gained. Results 5,265 CR and CRS matched patient pairs were identified. Surgery imparted an increased effectiveness of 0.83 life years, with an ICER of $17,618. Among non-academic centers, 1,634 matched CR and CRS patients demonstrated a benefit with surgery of 0.86 life years gained, for an ICER of $17,124. At academic centers, 3,201 matched CR and CRS patients had increased survival of 0.81 life years with surgery, for an ICER of $18,144. Finally, 3,713 CRS patients were matched between academic and non-academic centers. Academic center surgical patients had an increased effectiveness of 1.5 months gained and dominated the model with lower surgical cost estimates associated with lower 30-day mortality rates. Conclusions In Stage IIIA NSCLC, the selective addition of surgery to chemoradiation is cost-effective compared to definitive chemoradiation therapy at both non-academic and academic centers. These conclusions are valid over a range of clinically meaningful variations in cost and treatment outcomes.

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Pneumonectomy for lung cancer: Contemporary national early morbidity and mortality outcomes

Abstract: Several risk factors for major adverse early outcomes after pneumonectomy for cancer were identified. Overweight patients and those who received induction therapy had paradoxically lower adjusted risks of mortality.

Cited by 89 publications

References 28 publications

Risk factors for malignancy-unrelated long-term respiratory events after pneumonectomy

Risk factors for malignancy-unrelated long-term respiratory events after pneumonectomy

Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival

The Role of Surgical Resection in Stage IIIA Non-Small Cell Lung Cancer: A Decision and Cost-Effectiveness Analysis

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