HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Myrdal, G. Articles by Ståhle, E. Search for Related Content PubMed PubMed Citation Articles by Myrdal, G. Articles by Ståhle, E. Related Collections Lung - cancer

Eur J Cardiothorac Surg 2001;20:694-699
© 2001 Elsevier Science NL

Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity

^a Department of Thoracic and Cardiovascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala Sweden
^b Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden
^c Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden

Received 14 March 2001; received in revised form 2 June 2001; accepted 17 June 2001.

Corresponding author. Tel.:+46-18-6110000; fax:+46-18-551526
e-mail: gunnar.myrdal{at}thorax.uas.lul.se

Objective: This study was undertaken to assess mortality, complications and major morbidity during the first 30 days after lung cancer surgery and to estimate the significance of presurgical risk factors. Methods: The study was based on all patients referred for surgery for primary lung cancer from 1 January 1987 to 1 September 1999. There were in total 616 patients with primary lung cancer. Three-hundred and ninety-four were men and 222 women. Postoperative events studied were divided into major and minor complications or death during the first 30 days after surgery. The significance of risk factors for an adverse outcome (defined as death or major complication in the first 30 days postoperatively) was assessed by uni- and multivariate logistic regression analyses. Results: During the study period an increasing number of women and of patients older than 70 years underwent surgery. Overall 30-day mortality was 2.9, 0.6% after single lobectomy and 5.7% after pneumonectomy. Major complications occurred in 54 patients (8.8%). Fifty-eight patients (9.5%) had an adverse outcome during the first 30 days. Male gender, smoker, FEV₁70% of expected value, squamous cell carcinoma and pneumonectomy were risk factors predicting adverse outcome in the univariate model. Pneumonectomy and FEV₁70%, were the only independently significant factors for adverse outcome. Only pneumonectomy was independently associated with an increased risk for early death. Conclusion: Our results show low mortality and morbidity after lung cancer surgery. However, patients with reduced lung capacity and those undergoing pneumonectomy should be treated with great care, as they run a considerable risk of major complications or death during the first 30 days postoperatively. Older age (>70 years) does not appear to be a contraindication to lung cancer surgery, but patients in this group should undergo careful preoperative evaluation.

Key Words: Lung cancer • Postoperative complications • Pulmonary resections • Operative mortality • FEV_1%

This article has been cited by other articles:

				H. Rostad, T.-E. Strand, A. Naalsund, and J. Norstein Resected Synchronous Primary Malignant Lung Tumors: A Population-Based Study Ann. Thorac. Surg., January 1, 2008; 85(1): 204 - 209. [Abstract] [Full Text] [PDF]

				T.-E. Strand, H. Rostad, R. A M Damhuis, and J. Norstein Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude Thorax, November 1, 2007; 62(11): 991 - 997. [Abstract] [Full Text] [PDF]

				H. Weinstein, A. T. Bates, B. E. Spaltro, H. T. Thaler, and R. M. Steingart Influence of Preoperative Exercise Capacity on Length of Stay After Thoracic Cancer Surgery Ann. Thorac. Surg., July 1, 2007; 84(1): 197 - 202. [Abstract] [Full Text] [PDF]

				A. Shaw Genetics of postoperative complications following thoracic surgery. Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 327 - 345. [Abstract] [PDF]

				H. Rostad, T.-E. Strand, A. Naalsund, O. Talleraas, and J. Norstein Lung cancer surgery: the first 60 days. A population-based study. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 824 - 828. [Abstract] [Full Text] [PDF]

				O. Birim, A. P. Kappetein, T. Goorden, R. J. van Klaveren, and A. J.J.C. Bogers Proper Treatment Selection May Improve Survival in Patients With Clinical Early-Stage Nonsmall Cell Lung Cancer Ann. Thorac. Surg., September 1, 2005; 80(3): 1021 - 1026. [Abstract] [Full Text] [PDF]

				E. Perrot, B. Guibert, P. Mulsant, S. Blandin, I. Arnaud, P. Roy, L. Geriniere, and P.-J. Souquet Preoperative Chemotherapy Does Not Increase Complications After Nonsmall Cell Lung Cancer Resection Ann. Thorac. Surg., August 1, 2005; 80(2): 423 - 427. [Abstract] [Full Text] [PDF]

				G. Olgac, A. Olcmen, and C. A. Kutlu Is lactate dehydrogenase level really a reliable predictor of pulmonary morbidity than other co-morbid parameters following lung resection for NSCLC? Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 732 - 733. [Full Text] [PDF]

				H. Sakurai, H. Asamura, S.-i. Watanabe, K. Suzuki, and R. Tsuchiya Clinicopathologic features of peripheral squamous cell carcinoma of the lung Ann. Thorac. Surg., July 1, 2004; 78(1): 222 - 227. [Abstract] [Full Text] [PDF]

				T. Sundaramoorthi, S. Hashim, P. Dillon, R. Ramachandra, F. J. Collins, and M. D. Rosin An unusual cause of breathlessness after lobectomy for lung cancer Ann. Thorac. Surg., July 1, 2004; 78(1): e13 - e14. [Abstract] [Full Text] [PDF]

				L. L. Humphrey, S. Teutsch, and M. Johnson Lung Cancer Screening with Sputum Cytologic Examination, Chest Radiography, and Computed Tomography: An Update for the U.S. Preventive Services Task Force Ann Intern Med, May 4, 2004; 140(9): 740 - 753. [Abstract] [Full Text] [PDF]

				O. Birim, H. M. Zuydendorp, A. P.W.M. Maat, A. P. Kappetein, M. J. C. Eijkemans, and A. J.J.C. Bogers Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population Ann. Thorac. Surg., December 1, 2003; 76(6): 1796 - 1801. [Abstract] [Full Text] [PDF]

				M. Licker, M. de Perrot, A. Spiliopoulos, J. Robert, J. Diaper, C. Chevalley, and J.-M. Tschopp Risk Factors for Acute Lung Injury After Thoracic Surgery for Lung Cancer Anesth. Analg., December 1, 2003; 97(6): 1558 - 1565. [Abstract] [Full Text] [PDF]

				G Myrdal, S Valtysdottir, M Lambe, and E Stahle Quality of life following lung cancer surgery Thorax, March 1, 2003; 58(3): 194 - 197. [Abstract] [Full Text] [PDF]

				G. Myrdal, M. Lambe, G. Gustafsson, K. Nilsson, and E. Stahle Survival in primary lung cancer potentially cured by operation: influence of tumor stage and clinical characteristics Ann. Thorac. Surg., February 1, 2003; 75(2): 356 - 363. [Abstract] [Full Text] [PDF]

				A. J. Ploeg, A. P. Kappetein, R. B. van Tongeren, P. V. Pahlplatz, G. W. Kastelein, and P. J. Breslau Factors associated with perioperative complications and long-term results after pulmonary resection for primary carcinoma of the lung Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 26 - 29. [Abstract] [Full Text] [PDF]

				O. Birim, A.P.W.M. Maat, A.P. Kappetein, J.P. van Meerbeeck, R.A.M. Damhuis, and A.J.J.C. Bogers Validation of the Charlson comorbidity index in patients with operated primary non-small cell lung cancer Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 30 - 34. [Abstract] [Full Text] [PDF]