title: [Lung cancer surgery and cirrhosis].
abstract: BACKGROUND
  Lung cancer is the leading cause of death by cancer and cirrhosis is the fourteenth, all causes included. Surgery increases postoperative risks in cirrhotic patients. Our purpose was to analyze this point in lung cancer surgery.
  
  
  METHODS
  We collected, among 7162 patients, the data concerning those operated for lung cancer (n=6105) and compared patients with hepatic disease (n=448) to those presenting other medical disorder (n=2587). We analyzed cirrhotic patients' characteristics (n=49).
  
  
  RESULTS
  Five-year survival of patients with hepatic disease was lower (n=5657/6105): 35.3% versus 43.8% for patients with no hepatic disease, P=0.0021. Survival of cirrhotic patients was not statistically different from the one of patients with other hepatic disorder, but none survived beyond 10 years (0% versus 26.4%). Surgery in cirrhotic patients consisted in one explorative thoracotomy, three wedges resections, two segmentectomies, 33 lobectomies and 10 pneumonectomies. Postoperative mortality (8.2%; 4/49) was not different for patients without hepatic disease (4.2%; 239/5657) (P=0.32), as well as the rate of complications (40.8%; 20/49 and 24.8%; 1404/5657, P=0.11). Only one postoperative death was associated to a hepatic failure. Multivariate analysis pointed age, histological subtype of the tumour and stage of disease as independent prognosis factors.
  
  
  CONCLUSIONS
  When cirrhosis is well compensated, surgical resection of lung cancer can be performed with acceptable postoperative morbidity and satisfactory rates of survival. Progressive potential of this disease is worse after five years.
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Rivera
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: B
authors: B
authors: Chevalier
authors: Service d'oncologie médicale, université Paris Descartes, hôpital européen Georges-Pompidou, Paris, France.
authors: E
authors: E
authors: Fabre
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Pricopi
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: A
authors: A
authors: Badia
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: A
authors: A
authors: Arame
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Foucault
authors: Service de chirurgie thoracique, centre médico-chirurgical du Cèdre, Bois-Guillaume, France.
authors: A
authors: A
authors: Dujon
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors: F
authors: F
authors: Le Pimpec Barthes
authors: Service de chirurgie thoracique, université Paris-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. Electronic address: marc.riquet@egp.aphp.fr.
authors: M
authors: M
authors: Riquet
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016019:Survival Analysis
keywords: Cancer du poumon; Chirurgie; Cirrhose; Cirrhosis; Complication; Long-term survival; Lung cancer; Surgery; Survie à long terme