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Grapatsas K, Menghesha H, Dörr F, Baldes N, Schuler M, Stuschke M, Darwiche K, Taube C, Bölükbas S. Pneumonectomy for Primary Lung Tumors and Pulmonary Metastases: A Comprehensive Study of Postoperative Morbidity, Early Mortality, and Preoperative Clinical Prognostic Factors. Curr Oncol 2023; 30:9458-9474. [PMID: 37999105 PMCID: PMC10670891 DOI: 10.3390/curroncol30110685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Pneumonectomy is a major surgical resection that still remains a high-risk operation. The current study aims to investigate perioperative risk factors for postoperative morbidity and early mortality after pneumonectomy for thoracic malignancies. METHODS We retrospectively analyzed all patients who underwent pneumonectomy for thoracic malignancies at our institution between 2014 and 2022. Complications were assessed up to 30 days after the operation. Mortality for any reason was recorded after 30 days and 90 days. RESULTS A total of 145 out of 169 patients undergoing pneumonectomy were included in this study. The postoperative 30-day complication rate was 41.4%. The 30-day-mortality was 8.3%, and 90-day-mortality 17.2%. The presence of cardiovascular comorbidities was a risk factor for major cardiopulmonary complications (54.2% vs. 13.2%, p < 0.01). Postoperative bronchus stump insufficiency (OR: 11.883, 95% CI: 1.288-109.591, p = 0.029) and American Society of Anesthesiologists (ASA) score 4 (OR: 3.023, 95% CI: 1.028-8.892, p = 0.044) were independent factors for early mortality. CONCLUSION Pneumonectomy for thoracic malignancies remains a high-risk major lung resection with significant postoperative morbidity and mortality. Attention should be paid to the preoperative selection of patients.
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Affiliation(s)
- Konstantinos Grapatsas
- Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany; (H.M.); (F.D.); (N.B.); (S.B.)
| | - Hruy Menghesha
- Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany; (H.M.); (F.D.); (N.B.); (S.B.)
| | - Fabian Dörr
- Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany; (H.M.); (F.D.); (N.B.); (S.B.)
| | - Natalie Baldes
- Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany; (H.M.); (F.D.); (N.B.); (S.B.)
| | - Martin Schuler
- Department of Medical Oncology, West German Cancer Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany;
| | - Martin Stuschke
- Department of Radiation Oncology, West German Cancer Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany;
| | - Kaid Darwiche
- Department of Pneumology, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany; (K.D.); (C.T.)
| | - Christian Taube
- Department of Pneumology, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany; (K.D.); (C.T.)
| | - Servet Bölükbas
- Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany; (H.M.); (F.D.); (N.B.); (S.B.)
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Xie X, Li X, Tang W, Xie P, Tan X. Primary tumor location in lung cancer: the evaluation and administration. Chin Med J (Engl) 2021; 135:127-136. [PMID: 34784305 PMCID: PMC8769119 DOI: 10.1097/cm9.0000000000001802] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Lung cancer continues to be the leading cause of cancer-related death in the world, which is classically subgrouped into two major histological types: Non-small cell lung cancer (NSCLC) (85% of patients) and small-cell lung cancer (SCLC) (15%). Tumor location has been reported to be associated with the prognosis of various solid tumors. Several types of cancer often occur in a specific region and are more prone to spread to predilection locations, including colorectal cancer, prostate cancer, gastric cancer, ovarian cancer, cervical cancer, bladder cancer, lung tumor, and so on. Besides, tumor location is also considered as a risk factor for lung neoplasm with chronic obstructive pulmonary disease/emphysema. Additionally, the primary lung cancer location is associated with specific lymph node metastasis. And the recent analysis has shown that the primary location may affect metastasis pattern in metastatic NSCLC based on a large population. Numerous studies have enrolled the "location" factor in the risk model. Anatomy location and lobe-specific location are both important in prognosis. Therefore, it is important for us to clarify the characteristics about tumor location according to various definitions. However, the inconsistent definitions about tumor location among different articles are controversial. It is also a significant guidance in multimode therapy in the present time. In this review, we mainly aim to provide a new insight about tumor location, including anatomy, clinicopathology, and prognosis in patients with lung neoplasm.
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Affiliation(s)
- Xueqi Xie
- School of Medicine and Life Sciences, Shandong First Medical University, Jinan, Shandong 250117, China Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
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