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Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study.

Abstract：

Background:To assess possible differences in the perioperative profile between men and women in lung cancer surgery. Methods:A prospective cohort multicenter study was design, in which consecutive patients undergoing curative intent surgery for lung cancer in 24 Thoracic Services throughout Spain were included. Clinical features, tumor- and surgery-related data, postoperative complications, and mortality were recorded. Results:There were 2,566 men and 741 women. Women were younger than men [mean (SD) age, 61.8 (10.8) vs. 66.5 (9.1) years, P<0.0001] and showed a more favorable preoperative characteristics, with significantly higher percentages of ECOG grade 0 and lower percentages of active smokers (28.4% vs. 33.9%; pack-years 18.8 vs. 26.9) and comorbidities [chronic obstructive pulmonary disease (COPD), diabetes, hypertension, cardiac disorders]. There were significant differences (P<0.001) in histological types and TNM stages with adenocarcinoma (70.1% vs. 46.4%) and IA stage (41.5% vs. 33.6%) more frequent in women. The use of VATS or thoracotomy was similar. The rate of pneumonectomy was higher in men (10.9%) than in women (5.1%) (P<0.001) but the distributions of other procedures were similar. Postoperative complications (pneumonitis, atelectasis, air leak, hemorrhage, fistula, empyema, wound dehiscence, and need of reintubation) were lower in women. Significant differences (P<0.0001) in the severity of postoperative complications (Clavien-Dindo classification) were also found, with higher percentages of grades I (51.6% vs. 43%) and II (37.5% vs. 33%) and lower percentages of grades III and IV among women. The mean length of hospital stay was 7.8 (7.1) days in men versus 6.3 (5.0) days in women, and the 30-day mortality rate 0.3% in women versus 2.9% in men (P<0.0001). The percentage of readmissions within 30 days after surgery was also higher in men (8.6% vs. 2.8%). Conclusions:This multicenter nationwide study of lung cancer surgery with curative intent shows that the perioperative profile is better in women than in men.

journal_name

J Thorac Dis

journal_title

Journal of thoracic disease

authors

Fibla JJ,Molins L,Quero F,Izquierdo JM,Sánchez D,Hernández J,Bayarri C,Boada M,Guirao Á,Cueto A

doi

10.21037/jtd.2019.03.30

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1475-1484

issue

eissn

2072-1439

issn

2077-6624

pii

jtd-11-04-1475

journal_volume

pub_type

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Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study.