Factors associated with perioperative complications and long-term results after pulmonary resection for primary carcinoma of the lung.
OBJECTIVE
The aim of this study was to describe perioperative morbidity and mortality of patients presenting with resectable lung cancer and to investigate the long-term survival.


METHODS
We reviewed the records of 344 patients who underwent lung resection for bronchogenic carcinoma. Follow-up information was obtained from visits to the outpatient clinic.


RESULTS
Between January 1991 and December 1995 there were 263 males and 81 females included with a mean age of 65.7 years. One hundred and eight (31%) patients underwent a pneumonectomy, 159 (46%) a lobectomy, 43 (13%) a bilobectomy, four (1%) a segmental resection and 30 (9%) an explorative thoracotomy. A total of 341 complications occurred. The 30 day mortality rate was 7.9% (27 patients). Patients with a low FEV1% and older patients have a higher risk of mortality within 30 days. Postoperative myocardial infarction and pneumonia were associated with an increase in 30 day mortality. The median survival was 3.6 years for stage I, 1.9 years for stage II, 1.0 years for stage IIIa, 0.9 years for stage IIIb and 0.9 years for stage IV. Prognostic factors for the long-term survival included stage, pneumonectomy, percentage FEV1 <70, and large cell carcinoma.


CONCLUSIONS
Pulmonary resection can be performed at an acceptable risk. Critical reviewing of our results made it possible to make recommendations for improvements.
Ploeg
Arianne J
AJ
Department of Surgery, Red Cross Hospital, Sportlaan 600, 2566 MJ, The Hague, The Netherlands.
Kappetein
A Pieter
AP
van Tongeren
Robert B
RB
Pahlplatz
Paul V
PV
Kastelein
Gerard W
GW
Breslau
Paul J
PJ
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018287:Carcinoma, Large Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011014:Pneumonia / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate