PMID- 33034720 OWN - NLM STAT- MEDLINE DCOM- 20211007 LR - 20211007 IS - 1432-1750 (Electronic) IS - 0341-2040 (Linking) VI - 198 IP - 6 DP - 2020 Dec TI - Postoperative Adverse Events are Associated with Oncologic Recurrence Following Curative-intent Resection for Lung Cancer. PG - 973-981 LID - 10.1007/s00408-020-00395-6 [doi] AB - BACKGROUND: Up to 50% of patients suffer short-term postoperative adverse events (AEs) and metastatic recurrence in the long-term following curative-intent lung cancer resection. The association between AEs, particularly infectious in nature, and disease recurrence is controversial. We sought to evaluate the association of postoperative AEs on risk of developing recurrence and recurrence-free survival (RFS) following curative-intent lung resection surgery. METHODS: All lung cancer resections at a single institution (January 2008-July 2015) were included, with prospective collection of AEs using the Thoracic Morbidity & Mortality System. Cox proportional hazards models were used to estimate the effect of AEs on recurrence, with results presented as hazard ratio (HR) with 95% confidence interval (CI). An a priori, clinically driven approach to predictor variable selection was used. Kaplan-Meier curves were used examine the relationship between AE and RFS. p < 0.05 was considered statistically significant. RESULTS: 892 patients underwent curative-intent resection. 342 (38.3%) patients experienced an AE; 69 (7.7%) patients developed infectious AEs. 17.6% (n = 157) of patients had disease recurrence after mean follow-up of 26.5 months. Severe (Grade IV) AEs were associated with increased risk of recurrence (3.40; 95% CI 1.56-7.41) and a trend to decreased RFS. Major infectious AEs were associated with increased risk of recurrence (HR 1.71; CI 1.05-2.8) and earlier time to recurrence (no infectious AE 66 months, minor infectious 41 months, major infectious 54 months; p = 0.02). CONCLUSION: For patients undergoing curative-intent lung cancer resection, postoperative AEs associated with critical illness or major infection were associated with increased risk of oncologic recurrence. FAU - Gowing, Stephen AU - Gowing S AUID- ORCID: 0000-0003-0875-9540 AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Baker, Laura AU - Baker L AD - Division of General Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Canada. FAU - Tran, Alexandre AU - Tran A AD - Division of General Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Canada. FAU - Zhang, Zach AU - Zhang Z AD - Faculty of Medicine, The University of Ottawa, 501 Smyth Road, Ottawa, Canada. FAU - Ahn, Hilalion AU - Ahn H AD - Faculty of Medicine, The University of Ottawa, 501 Smyth Road, Ottawa, Canada. FAU - Ivanovic, Jelena AU - Ivanovic J AD - Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. FAU - Anstee, Caitlin AU - Anstee C AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Grigor, Emma AU - Grigor E AD - Faculty of Medicine, The University of Ottawa, 501 Smyth Road, Ottawa, Canada. FAU - Gilbert, Sebastien AU - Gilbert S AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Maziak, Donna E AU - Maziak DE AD - Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. AD - Faculty of Medicine, The University of Ottawa, 501 Smyth Road, Ottawa, Canada. AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Shamji, Farid AU - Shamji F AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Sundaresan, Sudhir AU - Sundaresan S AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Villeneuve, Patrick James AU - Villeneuve PJ AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. FAU - Seely, Andrew J E AU - Seely AJE AD - Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. aseely@toh.ca. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. aseely@toh.ca. AD - Faculty of Medicine, The University of Ottawa, 501 Smyth Road, Ottawa, Canada. aseely@toh.ca. AD - Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada. aseely@toh.ca. LA - eng PT - Journal Article DEP - 20201009 PL - United States TA - Lung JT - Lung JID - 7701875 SB - IM EIN - Lung. 2020 Nov 15;:. PMID: 33191453 MH - Adult MH - Aged MH - Aged, 80 and over MH - Canada MH - Disease-Free Survival MH - Female MH - Humans MH - Lung Neoplasms/diagnosis/*mortality/*surgery MH - Male MH - Middle Aged MH - Neoplasm Recurrence, Local/diagnosis/*epidemiology MH - Pneumonectomy/*adverse effects MH - Postoperative Complications/diagnosis/*epidemiology MH - Proportional Hazards Models MH - Risk Factors MH - Survival Rate MH - Treatment Outcome OTO - NOTNLM OT - Adverse events OT - Cancer recurrence OT - Infection OT - Lung cancer OT - Surgery EDAT- 2020/10/10 06:00 MHDA- 2021/10/08 06:00 CRDT- 2020/10/09 12:11 PHST- 2020/06/15 00:00 [received] PHST- 2020/09/25 00:00 [accepted] PHST- 2020/10/10 06:00 [pubmed] PHST- 2021/10/08 06:00 [medline] PHST- 2020/10/09 12:11 [entrez] AID - 10.1007/s00408-020-00395-6 [pii] AID - 10.1007/s00408-020-00395-6 [doi] PST - ppublish SO - Lung. 2020 Dec;198(6):973-981. doi: 10.1007/s00408-020-00395-6. Epub 2020 Oct 9.