Outcomes of surgery for lung cancer in patients with atrial fibrillation as a preoperative comorbidity: a decade of experience at a single institution in Japan.
OBJECTIVE
To investigate the surgical outcomes of surgery for non-small cell lung cancer (NSCLC) in patients with atrial fibrillation (AF) as a preoperative comorbidity.


METHODS
Among 805 patients who underwent surgery for NSCLC, 27 (3.4%) had a history of AF. We analyzed the perioperative and long-term outcomes of these 27 patients.


RESULTS
Fourteen patients (52%) had chronic AF and 13 (48%) had paroxysmal AF; being high rates of a comorbid illness. Nineteen patients (70%) underwent lobectomy, and 8 (30%) underwent sublobar resection. Ten patients (37%) received perioperative heparinization. There was no mortality. Other non-AF postoperative complications developed in 8 patients (30%), this incidence being higher than among the patients without AF (16%, 127 out of 778, p = 0.09). A thromboembolic event occurred in one patient (4%). With respect to the long-term outcomes, the 5-year overall survival and disease-free survival rates among the patients with AF were 70.3 and 60.8%, respectively, which were similar to those in the patients without AF (79.8 and 72.6%, p = 0.30 and 0.31).


CONCLUSIONS
Lung cancer surgery in patients with AF is safe and provides favorable long-term outcomes; however, thoracic surgeons should monitor these patients carefully for postoperative thromboembolic events.
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 General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Meinoshin
M
Okumura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011013:Pneumonectomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D057234:Preoperative Period; D013923:Thromboembolism / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D006493:Heparin
Atrial fibrillation; Lung cancer; Surgery