Pneumonectomy for stage i (T1N0 and T2N0) nonsmall cell lung cancer has potent, adverse impact on survival

Alexiou, Christos; Beggs, David; Onyeaka, Chinyere Vivian Patrick; Kotidis, Kostas; Ghosh, Sudip; Beggs, Lynda; Hopkinson, David; Duffy, John P.; Morgan, William E.; Rocco, Gaetano

doi:10.1016/s0003-4975(03)00883-x

Cited by 47 publications

(26 citation statements)

References 22 publications

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“…Within the first five post-operative days, cardiopulmonary complications occur in as many as 15-40% of patients and markedly prolong the hospital stay [140,[178][179][180][181][182]. Accordingly, implementation of evidence-based medical strategies as well as monitoring and treatment of high-risk patients in dedicated care units are aimed at improving the postoperative outcome while limiting healthcare expenses [183,184].…”

Section: Do We Need To Send All Thoracotomies To the Icu?mentioning

confidence: 99%

“…The task force team agreed to update and modify the algorithm based on the latest evidence [344,345] showing that, owing to the advances in surgical techniques (minimally invasive procedures, combination of lung cancer surgery with LVRS [178]) and the ongoing improvement in post-operative care, the limits of functional operability are constantly being lowered, thus allowing resections in patients who would have been deemed inoperable a few years ago. The algorithm emphasises the importance of a preliminary cardiological assessment ( fig.…”

Section: Algorithm For the Assessment Of Risk Before Lung Resectionmentioning

confidence: 99%

See 1 more Smart Citation

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

746

550

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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Section: Do We Need To Send All Thoracotomies To the Icu?mentioning

confidence: 99%

Section: Algorithm For the Assessment Of Risk Before Lung Resectionmentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

746

550

View full text Add to dashboard Cite

show abstract

“…Moreover, pneumonectomy has been reported to have a potent, independent adverse impact on survival in cancer patients [8].…”

mentioning

confidence: 99%

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Thomas¹,

Michelet²,

Thirion³

et al. 2007

European Respiratory Journal

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The aim of the present study was to determine the risk factors and impact on outcome of blood transfusions following pneumonectomy for thoracic malignancies.A retrospective analysis of 432 consecutive patients was carried out, of whom 183 (42.4%) were transfused post-operatively. The associations between blood transfusions and 20 variables were assessed by univariate and multivariate analysis. Survival analysis included log-rank test and Cox regression model.Patient age, neoadjuvant treatment, completion pneumonectomy and extended procedures were independent predictors of transfusion. It was found that 30-day mortality increased significantly from 2.4% (no transfusion) to 10.9 and 21.9% (f2 and .2 red blood cell packs, respectively). Blood transfusion was the strongest predictor of 30-day mortality (odds ratio (OR) 10; 95% confidence interval (CI): 3.7-27), respiratory failure (OR 19.2; 95% CI 7.4-49.4) and infectious complications (OR 3; 95% CI 1.5-6.2). In the 367 lung cancer patients, a significantly lower 5-yr survival was observed in univariate analysis of transfused patients (27.8¡5.4% versus 39.4¡4.5%). In a Cox regression analysis, blood transfusion was no longer found to be significant.A dose-related correlation is suggested between blood transfusion and early mortality through an increase of infectious and respiratory complications. In contrast, blood transfusion had no independent adverse impact on long-term survival.

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“…In addition to an immediate increased risk of mortality, pneumonetomy is also a strong adverse factor influencing longterm prognosis in patients with early stage lung cancer (74). This is particularly evident in patients with T1N0 stage in whom the 5-year survival after pneumonectomy is only 41% versus 68% after lesser resections.…”

Section: Pneumonectomymentioning

confidence: 99%

Preoperative functional workup for patients with advanced lung cancer

Brunelli

2016

J. Thorac. Dis.

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Locally advanced lung cancer remains a surgical indication in selected patients. This condition often demands larger resections. As a consequence preoperative functional workup is of paramount importance to stratify the risk and choose the most appropriate treatment. We reviewed the current evidence on functional evaluation with a special focus on specific aspects related to locally advanced lung cancer stages (i.e., risk after neoadjuvant treatment, pneumonectomy). Evidence is discussed to provide information that could assist clinicians in their preoperative workup of these challenging patients.

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Pneumonectomy for stage i (T1N0 and T2N0) nonsmall cell lung cancer has potent, adverse impact on survival

Cited by 47 publications

References 22 publications

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Preoperative functional workup for patients with advanced lung cancer

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