title: Impact of intraoperative blood loss on long-term survival after lung cancer resection.
abstract: OBJECTIVE
  The purpose of this study was to clarify relationships between intraoperative blood loss (IBL) and long-term postsurgical survival in lung cancer patients.
  
  
  METHODS
  We retrospectively analyzed 1336 patients undergoing surgery: lobectomy in 1016, sublobar resection in 174, pneumonectomy in 106, and combined resection with adjacent organs in 40. The lobectomy group was stratified further by pathologic stages; overall survival difference was examined according to amount of IBL.
  
  
  RESULTS
  Volume of IBL differed significantly according to surgical procedure when all patients were included. Within the lobectomy group, IBL differed significantly between gender, pathologic stage, histologic type (adenocarcinoma vs. non-adenocarcinoma), and year of operation (1983 to 2002 vs. 2003 to 2012). After stratification by pathologic stage, survival differed with IBL for stages IB to IIIB. Multivariate analysis identified gender, patients age (<69 vs. ≥69), pathologic stage (IA to IIB vs. IIIA to IV), year of operation, histologic type, and IBL as significant predictors of survival.
  
  
  CONCLUSIONS
  Since degree of IBL is an independent predictor of overall survival after lung cancer resection, IBL should be minimized carefully during surgery.
authors.affiliation: Department of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Saji
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kurimoto
authors.forename: Takuo
authors.initials: T
authors.lastname: Shinmyo
authors.forename: Rie
authors.initials: R
authors.lastname: Tagaya
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000367:Age Factors; D000368:Aged; D016063:Blood Loss, Surgical / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome