title: Simultaneous resection of pulmonary tumor following cardiovascular surgery.
abstract: BACKGROUND
  A pulmonary tumor is occasionally detected on a chest computed tomography (CT) scan before cardiovascular surgery.
  
  
  OBJECTIVE
  In this study, we examined clinical courses of patients who had undergone the simultaneous resection of a pulmonary tumor following cardiovascular surgery.
  
  
  METHODS
  From 2008 to 2013, 18 patients (13 men and 5 women) with a median age of 69.8 years underwent the wedge pulmonary resection for a lung tumor through a median thoracotomy following cardiovascular surgery in our hospital. Cardiovascular surgeries consisted of off-pump coronary artery bypass grafting (CABG) in six patients, aortic valve replacement and/or mitral valve plasty in 10 patients, total arch replacement in 10 patients and descending aorta replacement in 10 patients.
  
  
  RESULTS
  No complications associated with pulmonary resections were observed. Pathological examination revealed that 15 patients (83.3%) were diagnosed with lung cancers including 13 adenocarcinomas and two squamous cell carcinomas, with the clinical stages of 1A in 13 patients, 2A in one patient and 2B in one patient. Among them, five patients received the radical pulmonary resection subsequently, whereas 10 patients were unable to receive it due to their poor cardiopulmonary function. Kaplan-Meier analysis of patients with lung cancer revealed that the 5-year survival rate and progression-free survival (PFS) rate after 3 years from the surgery were 46.2% and 73.8%, respectively.
  
  
  CONCLUSIONS
  The simultaneous resection of pulmonary tumor following cardiovascular surgery is safely performed, and is useful for the pathological diagnosis of the tumor. Further studies are warranted, however, this procedure may contribute to controlling the progression of lung cancer in patients with cardiovascular disease with comorbidities.
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kaku
authors.affiliation: Department of Medical Oncology, Shiga University of Medical Science, Otsu, Japan. Electronic address: teramoto@belle.shiga-med.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Teramoto
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Igarashi
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kitamura
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tezuka
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Asai
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome
keywords: cardiovascular surgery; lung cancer; simultaneous surgery; thoracic surgery