The long-term impact of postoperative pulmonary complications after video-assisted thoracic surgery lobectomy for lung cancer.

Abstract:

Background:Pulmonary complications (PCs) may influence long-term survivor. We sought to determine the long-term impacts of major pulmonary complications (MPCs) and identify the independent risk factors in non-small cell lung cancer (NSCLC) patients. Methods:A retrospective study was conducted to analyze the PCs of 828 NSCLC patients who underwent video-assisted thoracic surgery (VATS) lobectomy in Peking University Hospital, the complications were graded according to TMM classification. The effects of PCs on the long-term prognosis were analyzed by using the Kaplan-Meier method. Multivariate logistic regression analysis was used to determine the risk factors of MPCs. Results:Of 828 patients, 139 had PCs, including 66 (8%) MPCs, those patients who developed a PC had longer drainage time, hospital stay and higher perioperative mortality rate. Excluding perioperative deaths, those who develop a MPC had a reduced 3-year disease-free survival (DFS) and 5-year DFS (68.2% vs. 78.7%, 44.7% vs. 70.3%; P=0.001), as well as the reduced 3-year overall survival (OS) and 5-year OS (81.8% vs. 88.6%, 66.6% vs. 80.9%; P=0.023). MPCs were independent prognostic factors of patients with lung cancer. Multivariate logistic regression analysis showed that the independent risk factors for MPCs were age [P=0.007; hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.01-1.08], male (P=0.001; HR: 3.33, 95% CI: 1.87-5.94) and American Society of Anesthesiologist (ASA) grade. Conclusions:MPC after VATS lobectomy is associated with a poorer long-time outcome. The independent risk factors for MPCs were age, male and ASA grade.

journal_name

J Thorac Dis

authors

Wang S,Li X,Li Y,Li J,Jiang G,Liu J,Wang J

doi

10.21037/jtd.2017.10.144

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

5143-5152

issue

12

eissn

2072-1439

issn

2077-6624

pii

jtd-09-12-5143

journal_volume

9

pub_type

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