Complications and long-term survival for alcoholic patients with resectable lung cancer.
BACKGROUND
The aim of this study was to determine the surgical risks and long-term survival in alcoholic patients undergoing resection for non-small-cell lung cancer.


METHODS
Nineteen resected patients comprising the alcoholic group were identified by either a Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis of alcohol dependence/abuse, or an alcohol consumption of 60 oz/d or more. Alcoholic patients were compared with 37 nonalcoholic patients undergoing resection.


RESULTS
Alcoholic patients had an increase in major infectious complications (37% [7 of 19] versus 5% [2 of 37], P = 0.005), respiratory failure (42% [8 of 19] versus 5% [2 of 37], P </=0.001), and costs ($49,526 +/- $17,525 versus $18,385 +/- $3,260, P = 0.01). Alcohol abuse was the best predictor of perioperative respiratory and infectious complications (P = 0.002, B = 2.86, odds ratio = 17.5). Stage of disease (P = 0.03, B = 1.19, hazard ratio = 3.29) was a better predictor of long-term survival.


CONCLUSIONS
Alcohol abuse significantly increases the risk and cost of lung cancer resection. For alcoholic patients surviving the perioperative period, long-term survival appears similar to non-alcohol-abusing patients.
Paull
Douglas E
DE
Department of Surgery, Wright State University School of Medicine, Veterans Administration Medical Center, 4100 W. Third St., Dayton, OH 45428, USA. douglas.paull@med.va.gov
Updyke
Glenda M
GM
Davis
Carolyn A
CA
Adebonojo
Samuel A
SA
D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality*; D011336:Probability; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome