Long-term outcome of surgical treatment for non-small cell lung cancer with comorbid liver cirrhosis.
BACKGROUND
Long-term outcome of surgery for non-small cell lung cancer with comorbid liver cirrhosis is not well known. We aimed to establish the factors influencing survival in such cases.


METHODS
We retrospectively reviewed 33 patients who had undergone surgery for non-small cell lung cancer with comorbid liver cirrhosis. Clinical features, early outcome, survival time, and cause of death were investigated. Factors influencing survival were estimated by univariate and multivariate analyses.


RESULTS
There were 2 in-hospital deaths (6.5%). Five-year survival rate for lung cancer death (n = 9) was 59.7%, whereas for hepatic death (n = 6), it was 62.9%. Factors influencing lung cancer death were nodal stage and limited resection (p < 0.05 for each). Factors influencing hepatic death were serum total bilirubin (p < 0.0001) and cholinesterase (p < 0.05), platelet count (p < 0.05), and alpha-fetoprotein (p < 0.05). Lung disease factors such as local extensiveness of the tumor and pathologic stage, and surgical factors such as performance of mediastinal dissection and limited surgery, also influenced survival from hepatic death (p < 0.05 for each).


CONCLUSIONS
Although pulmonary resection invasiveness may have some impact on long-term liver function, the life expectancy of patients with cirrhosis does not seem to be severely affected by pulmonary resection itself. Curative surgery should be performed if possible, even in patients with cirrhosis.
Iwata
Takashi
T
Department of Thoracic, Osaka City University Graduate School of Medicine, Osaka, Japan. taiwata@med.osaka-cu.ac.jp
Inoue
Kiyotoshi
K
Nishiyama
Noritoshi
N
Nagano
Koshi
K
Izumi
Nobuhiro
N
Mizuguchi
Shinjiro
S
Morita
Ryuhei
R
Tsukioka
Takuma
T
Suehiro
Shigefumi
S
D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000401:mortality / Q000601:surgery*; D002802:Cholinesterases / Q000097:blood; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D011183:Postoperative Complications / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D002802:Cholinesterases; D001663:Bilirubin