Author of

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  MINI 36 - Imaging and Diagnostic Workup (ID 163)

  • Event: WCLC 2015
  • Type: Mini Oral
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:F.(. Kong
  • Coordinates: 9/09/2015, 18:30 - 20:00, 401-404

  • 16009

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    MINI36.13 - Quantitative Computed Tomography as Predictor of Cardiopulmonary Complication after Lobectomy for Lung Cancer in COPD Patients (ID 1227)

    19:40 - 19:45  |  Author(s): N. Miyata
    • Abstract
    • Presentation
    • Slides

    Background:
    In lung cancer resection, COPD is a risk factor for postoperative complications. There are few reports about postoperative complications that assume a pictorial emphysematous change an index. We examine a relationship of an emphysematous regional ratio in preoperative CT in patients with COPD who underwent lung cancer resection and cardiopulmonary complication.
    
    Methods:
    One hundred fifty-nine patients with COPD who underwent lobectomy for lung cancer in our hospital from 2002 to 2011 were retrospectively evaluated in this study. Preoperative factors, including proportion of emphysematous area measured by CT (percentage of low attenuation area: LAA%), and operative factors were analyzed. Cardiopulmonary complications include pyothorax, pneumonia, atelectasis, acute pulmonary injury, chest tube indwelling, O~2~ long supply and arrythmia.
    
    Results:
    Cardiopulmonary complications were observed among 61 patients (38%). Ages, FEV1.0%, LAA% and amounts of blood lost were significantly relevant to cardiopulmonary complications by univariate analysis. Multivariate analysis indicated that patient’s age and LAA% could be significant independent predictors. Table1.Complications incidence by LAA%

    LAA%	N	complications：n=61	no complications：n=98	p value
    ～1% 1～10% 10%～	77 67 15	15(19.5%) 37(55.2%) 9(60.0%)	62(80.5%) 30(44.8%) 6(40.0%)	<0.001

    Table2. Operative factors in relation to cardiopulmonary complications

    variables	Odds ratio	95%Confidence Interval	p value
    Age(>70 years) FEV1.0% GOLD PaO2 LAA%（1%～） blood lost（>150ml）	4.612 1.042 2.044 0.973 5.570 2.073	2.028-10.489 0.973-1.117 0.857-4.876 0.940-1.008 2.302-13.480 0.878-4.894	＜0.001 0.242 0.107 0.128 ＜0.001 0.096

    
    
    Conclusion:
    LAA% is useful for predicting cardiopulmonary complications in patients with COPD undergoing lobectomy for lung cancer.In patients with COPD undergoing lobectomy for lung cancer, 70 years of age or older, the LAA% 1% or more of the cases, more careful intraoperative, and postoperative management are required.
    
    

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