Risk Factors for Early Mortality and Major Complications Following Pneumonectomy for Non-small Cell Carcinoma of the Lung

Licker, Marc; Spiliopoulos, Anastase; Frey, Jean-Georges; Robert, John; Hohn, Laurent; Perrot, Marc de; Tschopp, Jean‐Marie

doi:10.1378/chest.121.6.1890

Cited by 123 publications

(101 citation statements)

References 29 publications

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“…Other predictors, i.e. age, right-sided procedures and presence of coronary artery disease, had been also extensively reported previously [9][10][11][12]. The present results suggest infectious and respiratory complications as the causal pathway of that over mortality.…”

Section: Discussionsupporting

confidence: 87%

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Thomas¹,

Michelet²,

Thirion³

et al. 2006

Eur Respir J

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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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Section: Discussionsupporting

confidence: 87%

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Thomas¹,

Michelet²,

Thirion³

et al. 2006

Eur Respir J

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“…Pneumonectomy has been associated with higher morbidity/mortality and a worse 5-year survival rate after resection for NSCLC, compared to lobectomy or less advanced resection techniques [56][57][58] . This created the impression that limited anatomical resections in the form of single or double sleeve resections may be beneficial avoiding pneumonectomy related morbidity and mortality.…”

Section: Bronchoplastic Lung Resectionmentioning

confidence: 99%

Surgical strategies in the therapy of non-small cell lung cancer

Al-Shahrabani

Vallböhmer

Angenendt

et al. 2014

WJCO

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Lung cancer represents the leading cause of cancer mortality worldwide. Despite improvements in preoperative staging, surgical techniques, neoadjuvant/adjuvant options and postoperative care, there are still major difficulties in significantly improving survival, especially in locally advanced non-small cell lung cancer (NSCLC). To date, surgical resection is the primary mode of treatment for stage Ⅰ and Ⅱ NSCLC and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, in NSCLC patients with solitary distant metastases, surgical interventions have been discussed in the last years. Accordingly, this review displays the recent surgical strategies implemented in the therapy of NSCLC patients. Key words: Non-small cell lung cancer; Multimodality therapy; Surgical techniques; Neoadjuvant/adjuvant therapy; Solitary distant metastases Core tip: Lung cancer represents the leading cause of cancer mortality worldwide. To date, surgical resection is the primary mode of treatment for stage Ⅰ and Ⅱ non-small cell lung cancer (NSCLC) and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, individualized treatment options, based on clinical tumor stages, in NSCLC patients have been established in the last years that are displayed in this review.

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“…Patients undergoing major surgery are at substantial risk for postoperative morbidity, with 30-60 % of patients developing complications [24,25]. Endothelial dysfunction in the perioperative period may contribute to the risk of postoperative complications via impaired vascular homeostasis and resultant reduced tissue perfusion.…”

Section: Clinical Implications Of Perioperative Endothelial Dysfunctionmentioning

confidence: 99%

Perioperative Implications of Vascular Endothelial Dysfunction: Current Understanding of this Critical Sensor-Effector Organ

Riedel

Rafat

Browne

et al. 2013

Curr Anesthesiol Rep

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The endothelium, a delicate monolayer of cells lining all blood vessels, is a highly responsive sensoreffector organ, which through the secretion of a multitude of mediators, controls vascular tone, interacts with the inflammatory-coagulation cascades, promotes anti-aggregation, regulates immune cellular trafficking, and is crucial to angiogenesis. In brief, the endothelium is a major determinant of vascular homeostasis. It is easily damaged by intrinsic and extrinsic factors, and given its limited capacity for self-repair, is dependent on circulating bone marrow-derived endothelial progenitor cells for regeneration. There is increasing recognition that targeting the endothelium and maximizing inherent physiological function in the perioperative period may improve postoperative outcomes. This review explores the pathogenesis of endothelial dysfunction, the clinical utility of noninvasive methods to assess preoperative endothelial/microvascular (dys)function to improve risk stratification, and potential strategies for perioperative modulation of endothelial function.

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Risk Factors for Early Mortality and Major Complications Following Pneumonectomy for Non-small Cell Carcinoma of the Lung

Cited by 123 publications

References 29 publications

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Surgical strategies in the therapy of non-small cell lung cancer

Perioperative Implications of Vascular Endothelial Dysfunction: Current Understanding of this Critical Sensor-Effector Organ

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