Lung cancer stage is an independent risk factor for surgical mortality.
OBJECTIVE
To study surgical mortality and evaluate major risk factors, with specific focus on the role of pathological stage in patients undergoing lung cancer resection.


METHODS
Age, gender, comorbidity, resection volume, experience of the hospital and surgical team have been reported as variables related to postoperative morbidity and mortality in lung cancer. The role of pathological tumor stage on postoperative mortality has never been fully evaluated. The study included 1418 consecutive lung cancer resections performed from 1998 to 2002 in two institutions. The effect of age, gender, comorbidity, resection volume, pathological stage and induction therapies on postoperative mortality was assessed by univariable and multivariable logistic regression analysis.


RESULTS
Postoperative mortality was 1.8% overall, 3.7% (9/243) for pneumonectomy, 1.7% (17/1016) for lobectomy, and null (0/159) for sublobar resections (P = 0.020). At multivariable analysis, cardiovascular comorbidity (P = 0.008), resection volume (P = 0.036) and pathological stage (P = 0.027) emerged as significant predictors of surgical mortality.


CONCLUSIONS
Early stage lung cancer resection has a favorable effect on surgical mortality, not only by preventing the need for pneumonectomy, but also by reducing mortality after lobectomy.
Pastorino
Ugo
U
Istituto Nazionale Tumori, Milan, Italy. ugo.pastorino@istitutotumori.mi.it
Borasio
Piero
P
Francese
Massimo
M
Miceli
Rosalba
R
Calabrò
Elisa
E
Solli
Piergiorgio
P
Leo
Francesco
F
Novello
Silvia
S
Scagliotti
Giorgio
G
Mariani
Luigi
L
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013147:Spirometry