Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11601

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    P2.07-006 - Predicting factors for early and long term mortality and complications after thoracotomy in patients with primary lung cancer (ID 774)

    09:30 - 09:30  |  Author(s): D. Dumoulin
    • Abstract

    Background
    To determine factors predicting early and long term mortality and complications in patients who underwent a thoracotomy because of primary lung cancer.

    Methods
    Data of patients who underwent a thoracotomy in the Catharina Hospital Eindhoven between January 1995 and January 2011 have been collected retrospectively from the medical files. Early mortality was defined as mortality <30 days after surgery. Last date of follow up was January 1, 2013. Patients were divided in three groups according to date of surgery (1: 1995-1999, 2: 2000-2004 and 3: 2005-2010). Complications were divided into major and minor complications. Predicting factors were assessed with uni- and multivariate logistic regression analysis. For long-term mortality and survival predicting factors were assessed using the Cox proportional hazards model.

    Results
    In total 501 patients underwent a thoracotomy due to primary lung cancer. Overall 30 day mortality (early mortality) was 5.6% (n=28). Multivariate analysis showed that age over 70 (p=0.002), pneumonectomy (p=0.008) and a pre-operative VO2max of <15 ml/kg/min (p=0.02) were significant predictors of early mortality. With respect to long term survival, 308 (61%) patients had died at the end of the follow-up period. Median survival time was 44 months, with an overall 5- and 10- year survival of 45% and 27%, respectively. The 5-year survival for stage I, II and III-IV was 61%, 46% and 16%, respectively (p<0.0001, log rank test). Furthermore Cox regression analysis showed that stage (stage I, stage II compared to stage III-IV), FEV1% ≤70%, a history of cerebrovascular disease (CVD) and surgery in an earlier time period (1, 2 compared to 3) were significant predictors of long term mortality. Finally, the only significant predictor for major postoperative complications was a history of COPD (OR 2.32; 95% CI 1.38-3.91).

    Conclusion
    In this cohort, mortality and complication rates in lung cancer patients after thoracotomy were in line with literature. Significant predictors of early mortality were age, pneumonectomy and pre-operative VO2max. Significant predictors of long term mortality were disease stage, FEV1%, a history of CVD and surgery in an earlier time period.