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

This Article Full Text 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 Author home page(s): Jakob R. Izbicki Olaf Thetter Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Izbicki, J. R. Articles by Thetter, O. Search for Related Content PubMed PubMed Citation Articles by Izbicki, J. R. Articles by Thetter, O.

J Thorac Cardiovasc Surg 1995;110:386-395
© 1995 Mosby, Inc.

GENERAL THORACIC SURGERY

RISK ANALYSIS AND LONG-TERM SURVIVAL IN PATIENTS UNDERGOING EXTENDED RESECTION OF LOCALLY ADVANCED LUNG CANCER

Munich and Gauting, Germany

Received for publication June 2, 1994. Accepted for publication Dec. 8, 1994. Address for reprints: J.R. Izbicki, MD, Department of Surgery, Martinistr, 52, D-20251 Hamburg, Germany.

Abstract

Although locally advanced lung cancer frequently necessitates extended resections to preserve a chance for cure, a higher morbidity is associated with extended resections. It is not known whether the increased morbidity is of relevance for the long-term outcome. It also remains unclear whether exclusion of certain patients according to their risk factors can diminish mortality in these patients. This study therefore investigated whether certain risk factors predispose patients undergoing extended pulmonary resections to increased morbidity or mortality. It also assessed the long-term survival. The cases of 126 consecutive patients with locally advanced lung cancer (stage T3 or T4) were prospectively documented. Seventy-five percent of the patients required an extended resection and 25% a nonextended resection. Extended resections were associated with a significantly increased overall morbidity (p < 0.002). However, mortality, severe complications, or multiple complications were not significantly increased after extended resections. No risk factor predisposed to an increased mortality. Risk factors that were associated with particular postoperative complications were pathologic ergonometry (p < 0.002), a positive cardiac score (p < 0.003), coronary artery disease (p = 0.021), and an increased pulmonary risk score (p < 0.05). Overall 3-year survival was 31%. Patients undergoing extended resections for stage T3 or T4 tumors with no residual tumor (70% of the patients) showed a 3-year survival of 33%. We conclude that postoperative mortality cannot be reduced by excluding patients on the basis of particular risk factors from operations that require extended resections. If a patient is considered to be eligible to undergo pulmonary resection, he or she can be considered to be eligible to undergo extended pulmonary resection. Because prognosis is dismal in nonresected locally advanced lung cancer, we recommend an aggressive surgical approach.(J THORACCARDIOVASCSURG1995;110:386-95)

This article has been cited by other articles:

				H.-x. Yang, X. Hou, P. Lin, T.-h. Rong, H. Yang, and J.-h. Fu Survival and risk factors of surgically treated mediastinal invasion T4 non-small cell lung cancer. Ann. Thorac. Surg., August 1, 2009; 88(2): 372 - 378. [Abstract] [Full Text] [PDF]

				A. Borri, F. Leo, G. Veronesi, P. Solli, D. Galetta, R. Gasparri, F. Petrella, P. Scanagatta, D. Radice, and L. Spaggiari Extended pneumonectomy for non-small cell lung cancer: morbidity, mortality, and long-term results. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1266 - 1272. [Abstract] [Full Text] [PDF]

				P. E. Falcoz, M. Conti, L. Brouchet, S. Chocron, M. Puyraveau, M. Mercier, J. P. Etievent, and M. Dahan The Thoracic Surgery Scoring System (Thoracoscore): Risk model for in-hospital death in 15,183 patients requiring thoracic surgery J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 325 - 332. [Abstract] [Full Text] [PDF]

				Y. Matsubara, S.-i. Takeda, and T. Mashimo Risk Stratification for Lung Cancer Surgery: Impact of Induction Therapy and Extended Resection Chest, November 1, 2005; 128(5): 3519 - 3525. [Abstract] [Full Text] [PDF]

				R. Berrisford, A. Brunelli, G. Rocco, T. Treasure, M. Utley, and On behalf of the Audit and guidelines committee of The European Thoracic Surgery Database project: modelling the risk of in-hospital death following lung resection Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 306 - 311. [Abstract] [Full Text] [PDF]

				C. C.M. Pitz, A. B. de la Riviere, H. A. van Swieten, C. J.J. Westermann, J.-W. J. Lammers, and J. M.M. van den Bosch Results of surgical treatment of T4 non-small cell lung cancer Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 1013 - 1018. [Abstract] [Full Text] [PDF]

				A.E. Martin-Ucar, R. Nicum, I. Oey, J.G. Edwards, and D.A. Waller En-bloc chest wall and lung resection for non-small cell lung cancer. Predictors of 60-day non-cancer related mortality Eur. J. Cardiothorac. Surg., June 1, 2003; 23(6): 859 - 864. [Abstract] [Full Text] [PDF]

				A. Bernard, O. Bouchot, O. Hagry, and J. P. Favre Risk analysis and long-term survival in patients undergoing resection of T4 lung cancer Eur. J. Cardiothorac. Surg., August 1, 2001; 20(2): 344 - 349. [Abstract] [Full Text] [PDF]

				P. Goldstraw and X. Jiao Pericardial Repair After Extensive Resection: Another Use for the Pedicled Diaphragmatic Flap Ann. Thorac. Surg., April 1, 1996; 61(4): 1112 - 1114. [Abstract] [Full Text]