The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study
Abstract Background The presence of emphysema on computed tomography (CT) is associated with an increased frequency of lung cancer, but the postoperative outcomes of patients with pulmonary emphysema are not well known. The objective of this study was to investigate the association between the exten...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-019-0839-1 |
| _version_ | 1818305611654234112 |
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| author | Seijiro Sato Masaya Nakamura Yuki Shimizu Tatsuya Goto Terumoto Koike Hiroyuki Ishikawa Masanori Tsuchida |
| author_facet | Seijiro Sato Masaya Nakamura Yuki Shimizu Tatsuya Goto Terumoto Koike Hiroyuki Ishikawa Masanori Tsuchida |
| author_sort | Seijiro Sato |
| collection | DOAJ |
| description | Abstract Background The presence of emphysema on computed tomography (CT) is associated with an increased frequency of lung cancer, but the postoperative outcomes of patients with pulmonary emphysema are not well known. The objective of this study was to investigate the association between the extent of emphysema and long-term outcomes, as well as mortality and postoperative complications, in early-stage lung cancer patients after pulmonary resection. Methods The clinical records of 566 consecutive lung cancer patients who underwent pulmonary resection in our department were retrospectively reviewed. Among these, the data sets of 364 pathological stage I patients were available. The associations between the extent of lung emphysema and long-term outcomes and postoperative complications were investigated. Emphysema was assessed on the basis of semiquantitative CT. Surgery-related complications of Grade ≥ II according to the Clavien-Dindo classification were included in this study. Results Emphysema was present in 63 patients. The overall survival and relapse-free survival of the non-emphysema and emphysema groups at 5 years were 89.0 and 61.3% (P < 0.001), respectively, and 81.0 and 51.7%, respectively (P < 0.001). On multivariate analysis, significant prognostic factors were emphysema, higher smoking index, and higher histologic grade (p < 0.05). Significant risk factors for poor recurrence-free survival were emphysema, higher smoking index, higher histologic grade, and presence of pleural invasion (P < 0.05). Regarding Grade ≥ II postoperative complications, pneumonia and supraventricular tachycardia were more frequent in the emphysema group than in the non-emphysema group (P = 0.003 and P = 0.021, respectively). Conclusion The presence of emphysema affects the long-term outcomes and the development of postoperative complications in early-stage lung cancer patients. |
| first_indexed | 2024-12-13T06:29:21Z |
| format | Article |
| id | doaj.art-4c9e895d9a654567b2f74eeea15159bc |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-13T06:29:21Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-4c9e895d9a654567b2f74eeea15159bc2022-12-21T23:56:38ZengBMCBMC Pulmonary Medicine1471-24662019-04-0119111010.1186/s12890-019-0839-1The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective studySeijiro Sato0Masaya Nakamura1Yuki Shimizu2Tatsuya Goto3Terumoto Koike4Hiroyuki Ishikawa5Masanori Tsuchida6Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesAbstract Background The presence of emphysema on computed tomography (CT) is associated with an increased frequency of lung cancer, but the postoperative outcomes of patients with pulmonary emphysema are not well known. The objective of this study was to investigate the association between the extent of emphysema and long-term outcomes, as well as mortality and postoperative complications, in early-stage lung cancer patients after pulmonary resection. Methods The clinical records of 566 consecutive lung cancer patients who underwent pulmonary resection in our department were retrospectively reviewed. Among these, the data sets of 364 pathological stage I patients were available. The associations between the extent of lung emphysema and long-term outcomes and postoperative complications were investigated. Emphysema was assessed on the basis of semiquantitative CT. Surgery-related complications of Grade ≥ II according to the Clavien-Dindo classification were included in this study. Results Emphysema was present in 63 patients. The overall survival and relapse-free survival of the non-emphysema and emphysema groups at 5 years were 89.0 and 61.3% (P < 0.001), respectively, and 81.0 and 51.7%, respectively (P < 0.001). On multivariate analysis, significant prognostic factors were emphysema, higher smoking index, and higher histologic grade (p < 0.05). Significant risk factors for poor recurrence-free survival were emphysema, higher smoking index, higher histologic grade, and presence of pleural invasion (P < 0.05). Regarding Grade ≥ II postoperative complications, pneumonia and supraventricular tachycardia were more frequent in the emphysema group than in the non-emphysema group (P = 0.003 and P = 0.021, respectively). Conclusion The presence of emphysema affects the long-term outcomes and the development of postoperative complications in early-stage lung cancer patients.http://link.springer.com/article/10.1186/s12890-019-0839-1Lung cancerEmphysemaPulmonary resectionPrognosisPostoperative complications |
| spellingShingle | Seijiro Sato Masaya Nakamura Yuki Shimizu Tatsuya Goto Terumoto Koike Hiroyuki Ishikawa Masanori Tsuchida The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study BMC Pulmonary Medicine Lung cancer Emphysema Pulmonary resection Prognosis Postoperative complications |
| title | The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study |
| title_full | The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study |
| title_fullStr | The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study |
| title_full_unstemmed | The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study |
| title_short | The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study |
| title_sort | impact of emphysema on surgical outcomes of early stage lung cancer a retrospective study |
| topic | Lung cancer Emphysema Pulmonary resection Prognosis Postoperative complications |
| url | http://link.springer.com/article/10.1186/s12890-019-0839-1 |
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