Pneumonectomy for Treatment of Destroyed Lung: A Retrospective Study of 137 Patients

2016 ◽  
Vol 65 (07) ◽  
pp. 528-534 ◽  
Author(s):  
Yuping Li ◽  
Gening Jiang ◽  
Chang Chen ◽  
Xuefei Hu
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Operative Technique ◽  
Independent Risk Factor ◽  
Multivariate Analyses ◽  
Bronchopleural Fistula ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Destroyed Lung

Objectives Whether pneumonectomy is needed for the treatment of destroyed lungs is still controversial and unresolved in the clinic. Pneumonectomy is destructive and is associated with a significant incidence of postoperative complications. The purpose of this study is to analyze the operative techniques, postoperative morbidity, mortality, and long-term outcomes of patients with destroyed lungs who underwent pneumonectomy. Patients and Methods We retrospectively analyzed 137 patients with destroyed lungs who underwent pneumonectomy. The data were queried for the details of operative technique, development of perioperative complications, mortality, and long-term survival. Univariate and multivariate analyses were performed to investigate the risk factors of pneumonectomy among the patients. Results A total of 77 male and 60 female patients were reviewed. The youngest patient was 18 years, and the oldest was 75 years, with a mean age of 40.1 years. Postoperative complications were observed in 25 patients (18.2%). The rate of bronchopleural fistula (BPF) was 5.1% (7/137). Two perioperative deaths (1.5%) were noted. Univariate and multivariate analyses indicated the blood loss (hazard ratio [HR], 5.32; 95% confidence interval [CI], 1.27–18.50; p = 0.021) was the independent risk factor of postoperative complications, and the type of the disease (HR, 4.50; 95% CI, 1.19–9.69; p = 0.034) was the independent risk factor of the BPF, for the patients with destroyed lung after pneumonectomy. Conclusion Pneumonectomy for destroyed lung is a high risk for postoperative complications. Our findings suggested that pneumonectomy in destroyed lung was satisfactory with strict surgical indications, adequate preoperative preparation, and careful operative technique, and the long-term outcomes can be especially satisfactory. Pneumonectomy for destroyed lung is still a treatment option.

scholarly journals Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.

2020 ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Neuroendocrine Neoplasms ◽  
Radical Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Systemic Complications

Abstract Background: The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy.Methods: This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).Results: In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, incidences of serious postoperative complications were 0% and 3.7%, incidences of postoperative surgical complications were 13.6% and 15.2%, and incidences of postoperative systemic complications were 20.3% and 15.2%, respectively (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p=0.004; RFS: 52.54% vs 68.35%, p=0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p<0.05).Conclusions: Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

scholarly journals Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series

2020 ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Neuroendocrine Neoplasms ◽  
Radical Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Systemic Complications

Abstract Background: The relationship between sarcopenia and prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods: This study retrospectively collected data of 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results: In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS:42.37% vs 65.82%, p=0.004; RFS:52.54% vs 68.35%, p=0.036). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p<0.05).Conclusion: Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

scholarly journals Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.

2020 ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Neuroendocrine Neoplasms ◽  
Radical Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Systemic Complications

Abstract Background The relationship between sarcopenia and prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods This study retrospectively collected data of 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS:42.37% vs 65.82%, p = 0.004; RFS:52.54% vs 68.35%, p = 0.036). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p < 0.05). Conclusion Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

scholarly journals Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: results from a large, two-institution series

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Neuroendocrine Neoplasms ◽  
Radical Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Systemic Complications

Abstract Background The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9 and 30.4%, incidences of serious postoperative complications were 0 and 3.7%, incidences of postoperative surgical complications were 13.6 and 15.2%, and incidences of postoperative systemic complications were 20.3 and 15.2%, respectively (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p = 0.004; RFS: 52.54% vs 68.35%, p = 0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p < 0.05). Conclusions Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

scholarly journals The Clinical Utility of the Geriatric Nutritional Risk Index in Predicting Postoperative Complications and Long-Term Survival in Elderly Patients with Colorectal Cancer after Curative Surgery

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5852
Author(s):  
Chun-Kai Liao ◽  
Yih-Jong Chern ◽  
Yu-Jen Hsu ◽  
Yueh-Chen Lin ◽  
Yen-Lin Yu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Curative Surgery ◽  
Term Survival ◽  
Nutritional Risk Index

Research on the relationship between the geriatric nutritional risk index (GNRI) and postoperative complications/oncological outcomes in elderly colorectal cancer (CRC) patients is limited. This study investigated the prognostic value of the GNRI in aged CRC patients. We retrospectively analyzed 1206 consecutive CRC patients aged over 75 years who underwent curative-intent surgery from January 2008 to December 2015 and categorized them into high GNRI (≥98) and low GNRI (<98) groups according to a receiver operating characteristic (ROC) curve analysis. Uni- and multivariate logistic regression analysis were used to explore the association of the GNRI with postoperative complications. Kaplan–Meier survival analyses and the Cox proportional hazard model were used to explore the association between GNRI and survival. We discovered that GNRI is an independent risk factor for postoperative complications (HR: 1.774, p = 0.037). Surgical site infection, wound dehiscence and pneumonia were more common in patients with GNRI < 98. Survival analysis showed significantly worse overall survival and disease-free survival in the low GNRI group (both p < 0.001). In the multivariate analysis, GNRI < 98 was an independent risk factor for OS (HR: 1.329, p = 0.031) and DFS (HR: 1.312, p = 0.034). Thus, preoperative GNRI can be effectively used to predict postoperative complications and long-term survival in elderly CRC patients after curative surgery.

scholarly journals The Diameter of Bronchial Resection Margin is Associated With Postoperative Lung Metastasis and Long-term Survival

2020 ◽  
Author(s):  
Zengtuan Xiao ◽  
Mengzhe Zhang ◽  
Xiaofei Wang ◽  
Jialin Gong ◽  
Zuo Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Factor ◽  
Lung Metastasis ◽  
Independent Risk Factor ◽  
Resection Margin ◽  
Primary Lung Cancer ◽  
Term Survival ◽  
Long Term Survival ◽  
Bronchial Resection

Abstract BackgroundTo investigate the significance of the diameter of bronchial resection margin (DBRM) on the postoperative lung metastasis and long -term survival of patients with primary lung cancer.MethodsWe retrospectively analyzed the data of 1844 patients with primary lung cancer between January 2006 and December 2010 after surgery. Patients were divided into DBRM≤1 cm group (826 patients) and DBRM>1 cm group (1018 patients). Propensity score matching was used to reduce grouping selection bias. Furthermore, we divide the 974 patients who had definite first metastasis site into lung metastasis group (283 patients) and other metastasis group (691 patients), and analyzed related risk factors and prognosis of metastasis. Disease-free survival and overall survival were the study end points.ResultsThe DBRM≤1 cm group had a significantly better prognosis than DBTM>1 cm group (5-year DFS, 36.5% vs 25.7%; P < 0.001; 5-year OS, 45.4% vs 34.1%; P < 0.001). After multivariate survival analysis, DBRM remained the independent favorable effect on DFS (HR, 1.198; 95% CI, 1,071 to 1.340; P = 0.002) and OS (HR, 1.186; 95% CI, 1.060 to1.327; P = 0.003). PSM further confirmed that DBRM≤1 cm group had a better DFS (P = 0.032) and OS (P = 0.026) than the DBRM>1 cm group. It revealed that the DBRM was an independent risk factor for postoperative lung metastasis, and postoperative adjuvant therapy could improve the OS of lung metastases.ConclusionsThe DBRM was an independent risk factor for postoperative lung metastasis and adjuvant therapy could improve long-term survival.

scholarly journals Characteristics and long-term outcomes of patients with lupus-related protein-losing enteropathy: A retrospective study

2020 ◽  
Vol 1 (1) ◽  
pp. 47-52
Author(s):  
Liying Peng ◽  
Zhao Li ◽  
Dong Xu ◽  
Mengtao Li ◽  
Yanhong Wang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Protein Level ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Related Protein ◽  
Long Term Outcomes ◽  
Urine Protein ◽  
Protein Losing Enteropathy ◽  
Laboratory Test Results

AbstractObjectivesThe long-term outcomes of patients with systemic lupus erythematosus (SLE)-related protein-losing enter-opathy (PLE) are unclear. This study was aimed to investigate the clinical characteristics and long-term outcomes of patients with SLE-related PLE.MethodsThis retrospective cohort study enrolled 58 patients with SLE-related PLE who were admitted to our center from January 2000 to June 2016. The patients’ baseline characteristics and follow-up data were analyzed, and the prognostic outcomes were survival and disease flares. The prognoses were analyzed using Kaplan-Meier curves, log-rank tests, and Cox regression models. Factors with values of P<0.05 were considered potential predictors.ResultsTwo-thirds of patients had intestinal symptoms, and 77.6% of patients had concomitant organ/system involvement, including serositis (77.6%), lupus nephritis (57.6%), neuropsychiatric lupus (10.3%), and hematological disorders (22.4%). Common abnormalities in the laboratory test results were hypocomplementemia (87.9%), anti-Sjögren syndrome antigen A antibodies (51.7%), and high total cholesterol levels (62.1%). Five flares were recorded in 47 patients. The 1-, 3-, and 5-year survival rates were 93.6%, 91.3%, and 88.4%, respectively. Infection was the cause of death in 60% of patients. High 24-hour urine protein level was an independent risk factor associated with death (P = 0.012). Severe hypoalbuminemia (<12 g/L) was a predictor of disease flares in SLE-related PLE (hazard ratio, 10.345; 95% confidence interval, 1.690–63.321).ConclusionsInfection causes most of the deaths in patients with SLE-related PLE. High 24-hour urine protein level is an independent risk factor associated with death, and severe hypoalbuminemia is a predictor of disease flares.

scholarly journals Opportunistic screening and survival prediction of digestive cancers by the combination of blood mSEPT9 with protein markers

2020 ◽  
Vol 12 ◽  
pp. 175883592096296
Author(s):  
Lele Song ◽  
Yan Chen ◽  
Yuan Gong ◽  
Jun Wan ◽  
Shaohua Guo ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cancer Patients ◽  
Serum Protein ◽  
Independent Risk Factor ◽  
Opportunistic Screening ◽  
Protein Markers ◽  
Digestive Cancer ◽  
Term Survival ◽  
Digestive Cancers

Background: The early detection of digestive cancers and precancerous diseases remains a significant challenge. This study aimed to investigate the performance of the blood methylated SEPT9 ( mSEPT9) assay, and the combination of this assay with serum protein markers, in hospital-based opportunistic screening strategies for digestive cancers. Methods: Opportunistic screening was performed in the participating hospitals on outpatients and inpatients who met specific inclusion criteria. We recruited a total of 2030 subjects, including 764 cancer patients [291 colorectal cancer (CRC), 239 gastric cancer (GC), 106 esophageal cancer (EC), and 128 hepatocellular carcinoma (HCC)], 423 subjects with precancerous diseases, and 843 normal subjects. All samples were transported to an authenticated clinical laboratory where the mSEPT9 tests were performed. Results: When used separately, the mSEPT9 detected CRC, GC, EC, and HCC, with a sensitivity of 76.6% [area under the receiver operating characteristic curve (AUC) = 0.86)], 47.7% (AUC = 0.76), 42.6% (AUC = 0.69), and 76.7% (AUC = 0.85) and a specificity of 94.6%, 92.3%, 92.5%, and 87.7%, respectively. The mSEPT9 assay also had potent ability to discriminate cancer from non-cancer subjects. The combination of mSEPT9 with CEA, CA724, SNCG, or AFP significantly enhanced the sensitivity for CRC, GC, EC, and HCC to 86.4% (AUC = 0.99, specificity = 92.8%), 63.6% (AUC = 0.86, specificity = 91.1%), 71.3% (AUC = 0.81, specificity = 82.1%), and 83.3% (AUC = 0.93, specificity = 85.1%), respectively. The performance of the mSEPT9 assay was influenced by cancer stage, patient age, pathological types, and the location of cancer. We also identified that mSEPT9 was an independent risk factor and was a valuable predictor for the long-term survival of digestive cancer patients, with a hazard ratio of 2.84, 2.07, 1.88, and 2.45, for CRC, GC, EC, and HCC, respectively. Conclusion: The blood mSEPT9 assay, whether used alone or in combination with serum protein markers, is effective for the opportunistic screening of digestive cancers. Furthermore, mSEPT9 is an independent risk factor and a predictive marker for the long-term survival of digestive cancer patients.

Sign in / Sign up

Export Citation Format

Share Document