Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients
Background: Surgery remains the gold standard for patients with resectable nonsmall cell lung cancer. Current guidance identifies patients with poor pulmonary reserve to fall within a high-risk cohort. The aim of this study was to determine the clinical and quality of life outcomes of anatomical lun...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
|
| Series: | Annals of Thoracic Medicine |
| Subjects: | |
| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2017;volume=12;issue=2;spage=83;epage=87;aulast=Wilson |
| _version_ | 1819181007744532480 |
|---|---|
| author | Henrietta Wilson David Gammon Tom Routledge Karen Harrison-Phipps |
| author_facet | Henrietta Wilson David Gammon Tom Routledge Karen Harrison-Phipps |
| author_sort | Henrietta Wilson |
| collection | DOAJ |
| description | Background: Surgery remains the gold standard for patients with resectable nonsmall cell lung cancer. Current guidance identifies patients with poor pulmonary reserve to fall within a high-risk cohort. The aim of this study was to determine the clinical and quality of life outcomes of anatomical lung resection in patients deemed high risk based on pulmonary function measurements.
Methods: A retrospective review of patients undergoing anatomical lung resection for nonsmall cell lung cancer between January 2013 and January 2015 was performed. All patients with limited pulmonary reserve defined as predicted postoperative forced expiratory volume in 1 s or transfer factor of the lung for carbon monoxide of <40% were included in the study. Postoperative complications, admission to the Intensive Care Unit, length of stay, and 30-day in-hospital mortality were recorded. The European Organization for Research and Treatment of Cancer quality of life questionnaire lung cancer 13 questionnaire was used to assess quality of life outcomes.
Results: Fifty-three patients met the inclusion criteria. There was no in-hospital mortality, and 30-day mortality was 1.8%. No complications were seen in 64% (n = 34), minor complications occurred in 26% (n = 14), while 9% had a major complication (n = 5). Quality of life outcomes were above the reference results for patients with early stage lung cancer.
Conclusion: Anatomical lung resection can be performed safely in selected high-risk patients based on pulmonary function without significant increase in morbidity or mortality and with acceptable quality of life outcomes. Given that complications following lung resection are multifactorial, fitness for surgery should be thoroughly assessed in all patients with resectable disease within a multidisciplinary setting. High operative risk by pulmonary function tests alone should not preclude surgical resection. |
| first_indexed | 2024-12-22T22:23:23Z |
| format | Article |
| id | doaj.art-f01352bdc5c048a0803eaccc30421c08 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-12-22T22:23:23Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-f01352bdc5c048a0803eaccc30421c082022-12-21T18:10:37ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572017-01-01122838710.4103/atm.ATM_385_16Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patientsHenrietta WilsonDavid GammonTom RoutledgeKaren Harrison-PhippsBackground: Surgery remains the gold standard for patients with resectable nonsmall cell lung cancer. Current guidance identifies patients with poor pulmonary reserve to fall within a high-risk cohort. The aim of this study was to determine the clinical and quality of life outcomes of anatomical lung resection in patients deemed high risk based on pulmonary function measurements. Methods: A retrospective review of patients undergoing anatomical lung resection for nonsmall cell lung cancer between January 2013 and January 2015 was performed. All patients with limited pulmonary reserve defined as predicted postoperative forced expiratory volume in 1 s or transfer factor of the lung for carbon monoxide of <40% were included in the study. Postoperative complications, admission to the Intensive Care Unit, length of stay, and 30-day in-hospital mortality were recorded. The European Organization for Research and Treatment of Cancer quality of life questionnaire lung cancer 13 questionnaire was used to assess quality of life outcomes. Results: Fifty-three patients met the inclusion criteria. There was no in-hospital mortality, and 30-day mortality was 1.8%. No complications were seen in 64% (n = 34), minor complications occurred in 26% (n = 14), while 9% had a major complication (n = 5). Quality of life outcomes were above the reference results for patients with early stage lung cancer. Conclusion: Anatomical lung resection can be performed safely in selected high-risk patients based on pulmonary function without significant increase in morbidity or mortality and with acceptable quality of life outcomes. Given that complications following lung resection are multifactorial, fitness for surgery should be thoroughly assessed in all patients with resectable disease within a multidisciplinary setting. High operative risk by pulmonary function tests alone should not preclude surgical resection.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2017;volume=12;issue=2;spage=83;epage=87;aulast=WilsonAnatomical lung resectionhigh-risk patientsnonsmall cell lung cancer |
| spellingShingle | Henrietta Wilson David Gammon Tom Routledge Karen Harrison-Phipps Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients Annals of Thoracic Medicine Anatomical lung resection high-risk patients nonsmall cell lung cancer |
| title | Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients |
| title_full | Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients |
| title_fullStr | Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients |
| title_full_unstemmed | Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients |
| title_short | Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients |
| title_sort | clinical and quality of life outcomes following anatomical lung resection for lung cancer in high risk patients |
| topic | Anatomical lung resection high-risk patients nonsmall cell lung cancer |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2017;volume=12;issue=2;spage=83;epage=87;aulast=Wilson |
| work_keys_str_mv | AT henriettawilson clinicalandqualityoflifeoutcomesfollowinganatomicallungresectionforlungcancerinhighriskpatients AT davidgammon clinicalandqualityoflifeoutcomesfollowinganatomicallungresectionforlungcancerinhighriskpatients AT tomroutledge clinicalandqualityoflifeoutcomesfollowinganatomicallungresectionforlungcancerinhighriskpatients AT karenharrisonphipps clinicalandqualityoflifeoutcomesfollowinganatomicallungresectionforlungcancerinhighriskpatients |