title: Early complications in surgical treatment of lung cancer: a prospective, multicenter study. Grupo Cooperativo de Carcinoma Broncogénico de la Sociedad Española de Neumología y Cirugía Torácica.
abstract: BACKGROUND
  We prospectively analyzed the postoperative morbidity, mortality rate, and risk factors in 605 patients who underwent thoracotomy for bronchogenic carcinoma.
  
  
  METHODS
  Patients were categorized by postsurgical tumor stage: I, 287 patients (47.4%); II, 49 patients (8.1%); IIIA, 154 patients (25.5%); IIIB, 80 patients (13.2%); IV, 16 patients (2.7%); unavailable, 19 patients (3.1%). Two hundred ninety-four patients (48.6%) underwent lobectomy, 172 (28.4%) pneumonectomy, 20 (3.3%) bilobectomy, 29 (4.8%) segmentectomy, 27 (4.5%) wedge resection, and 63 (10.4%) exploratory thoracotomy. The importance of the factors that influence the morbidity and mortality rates was calculated from their relative risks. Univariate and multivariate methods for a logistic regression model were used for this analysis.
  
  
  RESULTS
  Postoperative complications developed in 196 patients (32.4%); there were 165 (27.3%) cases of operation-related complications and 152 (25.1%) cases of respiratory and cardiovascular complications. The morbidity rate was highest in patients with preexisting vascular disease (50.9%; odds ratio [OR], 2.20) or insulin-dependent diabetes mellitus (52.4%; OR, 2.77) and in patients who underwent pneumonectomy (40.1%; OR, 1.82). Forty patients (6.6%) died postoperatively, most commonly of respiratory failure (67.5%). The mortality rate was highest in patients with postoperative morbidity (OR, 31.9) or vascular disease (15.8%; OR, 2.83) and in patients who underwent pneumonectomy (13.4%; OR, 4.9).
  
  
  CONCLUSIONS
  Postoperative complications are more likely to develop in patients with peripheral vascular disease or insulin-dependent diabetes mellitus, or both. Postoperative mortality was found to be significantly higher in patients with vascular disease and those who underwent pneumonectomy.
authors.affiliation: Thoracic Surgery Service, Hospital Universitario, Valladolid, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Duque
authors.forename: G
authors.initials: G
authors.lastname: Ramos
authors.forename: J
authors.initials: J
authors.lastname: Castrodeza
authors.forename: J
authors.initials: J
authors.lastname: Cerezal
authors.forename: M
authors.initials: M
authors.lastname: Castanedo
authors.forename: M G
authors.initials: MG
authors.lastname: Yuste
authors.forename: F
authors.initials: F
authors.lastname: Heras
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002283:Carcinoma, Bronchogenic / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D009017:Morbidity; D016017:Odds Ratio; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D011446:Prospective Studies