Treatment of simultaneously discovered lung cancer and cardiovascular disease: a 20-year single-institution experience.
OBJECTIVE
To propose a treatment strategy for simultaneously discovered non-small cell lung cancer (NSCLC) and cardiovascular disease (CVD).


METHODS
Of 1302 patients who underwent surgery for NSCLC, CVD requiring invasive treatment was simultaneously discovered in 33 (3 %). The details of the treatments as well as the short- and long-term outcomes of pulmonary resection were analyzed.


RESULTS
CVD included coronary artery disease in 20 patients, valvular disease in 6, abdominal aortic aneurysm in 5, and congenital heart disease in 2. Twenty-six patients underwent two-stage treatment, while seven received simultaneous surgery. In 23 patients whose treatment for CVD preceded that for lung cancer, the median interval between those treatments was 78 days (range 18-197 days). Postoperative complications occurred in 8 (31 %) of 26 patients who underwent 2-stage treatment and in 3 (43 %) of 7 who underwent simultaneous surgery. Notably, of 3 patients who underwent lobectomy or bilobectomy, 2 (67 %) experienced respiratory dysfunction that required intubation. The 5-year overall survival rate of all 33 patients was 84.5 %.


CONCLUSIONS
The outcomes of two-stage treatment in the present cohort were favorable. Given our experience, simultaneous surgery for lung cancer and CVD should, therefore, be selected only for patients who may benefit from that strategy.
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. rkanzaki@tj8.so-net.ne.jp.
Ryu
R
Kanzaki
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Toru
T
Kimura
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Tomohiro
T
Kawamura
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Soichiro
S
Funaki
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Yasushi
Y
Shintani
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Masato
M
Minami
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Shigeru
S
Miyagawa
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Koichi
K
Toda
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Yoshiki
Y
Sawa
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Meinoshin
M
Okumura
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
Cardiovascular disease; Comorbidity; Lung cancer; Surgery
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