Differential impacts of postoperative complications on patients’ survival in completely resected non-small-cell lung cancer

• Published in: General thoracic and cardiovascular surgery Vol. 69; no. 9; pp. 1283 - 1290
• Main Authors: Kadomatsu, Yuka, Tsubouchi, Hideki, Nakanishi, Keita, Sugiyama, Tomoshi, Ueno, Harushi, Goto, Masaki, Ozeki, Naoki, Nakamura, Shota, Fukui, Takayuki, Chen-Yoshikawa, Toyofumi Fengshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.09.2021; Springer Nature B.V
• Subjects: Body mass index; Cardiac arrhythmia; Cardiac Surgery; Cardiology; Fistula; Hospitals; Length of stay; Lung cancer; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Multivariate analysis; Original Article; Patients; Pneumonia; Surgical Oncology; Thoracic Surgery; Variables; United States > US; Complication; Thoracic surgery; Overall survival; Long-term effect; Non-small cell lung cancer
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-021-01619-z

Objective The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. Methods Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan–Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. Results Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41–4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70–2.70). Conclusions Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.