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. 2017 Dec;9(12):5143-5152.
doi: 10.21037/jtd.2017.10.144.

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

Shaodong Wang  1 , Xiao Li  1 , Yun Li  1 , Jianfeng Li  1 , Guanchao Jiang  1 , Jun Liu  1 , Jun Wang  1
Affiliations

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

Shaodong Wang et al. J Thorac Dis. 2017 Dec.

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.

Keywords: American Society of Anesthesiologist (ASA); Video-assisted thoracic surgery (VATS); lung cancer, major pulmonary complication (MPC).

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
DFS of patients with and without pulmonary complications. Blue line: no PCs; grey line: PCs. DFS, disease-free survival; PC, pulmonary complication.
Figure 2
Figure 2
OS of patients with and without PCs. Blue line: no PCs; grey line: PCs. OS, overall survival; PC, pulmonary complication.
Figure 3
Figure 3
DFS of patients with and without MPCs. Blue line: no MPCs; grey line: MPCs. DFS, disease-free survival; MPC, major pulmonary complication.
Figure 4
Figure 4
OS of patients with and without MPCs. Blue line: no MPCs; grey line: MPCs. OS, overall survival; MPC, major pulmonary complication.
See this image and copyright information in PMC

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