PMID- 12754038
OWN - NLM
STAT- MEDLINE
DCOM- 20030814
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 23
IP  - 5
DP  - 2003 May
TI  - The impact of cardiovascular comorbidity on the outcome of surgery for stage I 
      and II non-small-cell lung cancer.
PG  - 811-7
AB  - OBJECTIVE: The association between lung malignancy and cardiovascular disease has 
      been frequently reported though its therapeutic and prognostic implications not 
      thoroughly analyzed. This study aims at assessing the possible impact of 
      coexisting cardiovascular disease on the outcome of surgical treatment of non 
      small cell lung cancer (NSCLC). METHODS: Among 247 consecutive patients undergone 
      surgery for stage I and II NSCLC between 1990 and 1997, 34 (13.7%) had a 
      cardiovascular comorbidity going to be treated by surgery, namely coronary artery 
      disease (n=14), carotid stenosis (n=21), abdominal aortic aneurysm (n=9) and 
      lower limbs arteriopathy (n=7). Among 22 patients (64.7%) who underwent 
      cardiac/vascular surgery first, operation was performed after a median interval 
      of 4.5 weeks. In five of this subset lung cancer was incidentally detected. In 
      the other patients the cardiovascular disease was diagnosed and treated after the 
      lung cancer had been detected and operated with a median interval of 3.5 months 
      from thoracic procedure. Surgical procedures for lung cancer were three 
      pneumonectomies, 12 lobectomies, 19 wedge resections. Uni and multivariate 
      analysis for risk factors was carried out. RESULTS: In the group with 
      cardiovascular comorbidity overall postoperative mortality was 9%, while 
      morbidity rate was 58.8%, both of them primarily caused by cardiovascular disease 
      and significantly higher for major resections. The 3- and 5-year survival rates 
      were 54.8% and 35.5% compared to 69.2% and 56.4% among patients without 
      cardiovascular comorbidity (P=0.01) while the timing of vascular surgery (before 
      or after thoracic procedure) did not significantly affect survival. Multifocal 
      vascular disease resulted the only positive factor at multivariate analysis 
      (P=0.005, Odd Ratio=3.51, 95% Confidence Interval=1.4-8.4). CONCLUSIONS: 
      Cardiovascular disease seems to have significant impact on survival and morbidity 
      in patients undergone surgery for lung cancer, especially in presence of 
      multifocal vascular disease and following major resections. The timing of 
      vascular surgery and the extension of resection should rely on the severity of 
      vascular disease, anaesthesiologist's and surgeon's final evaluation.
FAU - Ambrogi, Vincenzo
AU  - Ambrogi V
AD  - Department of Thoracic Surgery, Tor Vergata University, Rome, Italy.
FAU - Pompeo, Eugenio
AU  - Pompeo E
FAU - Elia, Stefano
AU  - Elia S
FAU - Pistolese, Giuseppe Raimondo
AU  - Pistolese GR
FAU - Mineo, Tommaso Claudio
AU  - Mineo TC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 2004 Feb;25(2):297. PMID: 14747136
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/complications/*surgery
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/complications/*surgery
MH  - Male
MH  - Middle Aged
MH  - Reoperation
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Vascular Diseases/*complications/surgery
EDAT- 2003/05/20 05:00
MHDA- 2003/08/15 05:00
CRDT- 2003/05/20 05:00
PHST- 2003/05/20 05:00 [pubmed]
PHST- 2003/08/15 05:00 [medline]
PHST- 2003/05/20 05:00 [entrez]
AID - S1010794003000939 [pii]
AID - 10.1016/s1010-7940(03)00093-9 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2003 May;23(5):811-7. doi: 
      10.1016/s1010-7940(03)00093-9.