F-078DESIGN OF AN EFFICIENT FOLLOW-UP SCHEME THROUGH THE ANALYSIS OF FACTORS INFLUENCING SHORT- AND LONG-TERM SURVIVAL OF PATIENTS UNDERGOING LUNG RESECTION FOR LUNG CANCER

Objectives Overdiagnosis in low-dose computed tomography randomized screening trials varies from 0 to 67%. The National Lung Screening Trial (extended follow-up) and ITALUNG (Italian Lung Cancer Screening Trial) have reported cumulative incidence estimates at long-term follow-up showing low or no overdiagnosis. The Danish Lung Cancer Screening Trial attributed the high overdiagnosis estimate to a likely selection for risk of the active arm. Here, we applied a method already used in benefit and overdiagnosis assessments to compute the long-term survival rates in the ITALUNG arms in order to confirm incidence-excess method assessment. Methods Subjects in the active arm were invited for four screening rounds, while controls were in usual care. Follow-up was extended to 11.3 years. Kaplan-Meyer 5- and 10-year survivals of “resected and early” (stage I or II and resected) and “unresected or late” (stage III or IV or not resected or unclassified) lung cancer cases were compared between arms. Results The updated ITALUNG control arm cumulative incidence rate was lower than in the active arm, but this was not statistically significant (RR: 0.89; 95% CI: 0.67–1.18). A compensatory drop of late cases was observed after baseline screening. The proportion of “resected and early” cases was 38% and 19%, in the active and control arms, respectively. The 10-year survival rates were 64% and 60% in the active and control arms, respectively ( p = 0.689). The five-year survival rates for “unresected or late” cases were 10% and 7% in the active and control arms, respectively ( p = 0.679). Conclusions This long-term survival analysis, by prognostic categories, concluded against the long-term risk of overdiagnosis and contributed to revealing how screening works.

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Safety and Feasibility of Thoracoscopic Lung Resection for Non-Small-Cell Lung Cancer in Octogenarians

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/1556984520971620 ◽

2020 ◽

pp. 155698452097162

Author(s):

Xiaoying Lou ◽

Andrew Sanders ◽

Kaustubh Wagh ◽

Jose N. Binongo ◽

Manu Sancheti ◽

...

Keyword(s):

Lung Cancer ◽

Cox Regression ◽

Lung Resection ◽

Small Cell ◽

Small Cell Lung ◽

Preoperative Risk ◽

Term Survival ◽

Long Term Survival ◽

Cox Regression Analysis

Objective Octogenarians comprise an increasing proportion of patients presenting with non-small-cell lung cancer (NSCLC). This study examines postoperative morbidity and mortality, and long-term survival in octogenarians undergoing thoracoscopic anatomic lung resection for NSCLC, compared with younger cohorts. Methods We conducted a retrospective review of our institutional Society of Thoracic Surgeons General Thoracic Surgery Database of all patients ≥60 years old undergoing elective lobectomy or segmentectomy for pathologic stage I, II, and IIIA NSCLC between 2009 and 2018. Results were compared between octogenarians ( n = 71) to 2 younger cohorts of 60- to 69-year-olds ( n = 359) and 70- to 79-year-olds ( n = 308). Long-term survival among octogenarians was graphically summarized using the Kaplan–Meier method. Cox regression analysis was used to identify preoperative risk factors for mortality. Results A greater proportion of octogenarians required intensive care unit admission and discharge to extended-care facilities; however, postoperative length of stay was similar between groups. Among postoperative complications, arrhythmia and renal failure were more likely in the older cohort. Compared to the youngest cohort, in-hospital and 30-day mortality were highest among octogenarians. Overall survival among octogenarians at 1, 3, and 5 years was 87.3%, 61.8%, and 50.5%, respectively. On multivariable Cox regression analysis of baseline demographic variables, presence of stroke (hazard ratio [HR] = 28.5, 95% confidence interval [CI]: 6.1 to 132.7, P < 0.001) and coronary artery disease (HR = 2.5, 95% CI: 1.2 to 5.3, P = 0.02) were significant predictors of overall mortality among octogenarians. Conclusions Thoracoscopic resection can be performed with favorable early postoperative outcomes among octogenarians. Long-term survival, although comparable to their healthy peers, is worse than those of younger cohorts. Further study into preoperative risk stratification and alternative therapies among octogenarians is needed.

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Long-term survival after lung resection for non–small cell lung cancer with circulatory bypass: A systematic review

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2011.07.042 ◽

2011 ◽

Vol 142 (5) ◽

pp. 1137-1142 ◽

Cited By ~ 23

Author(s):

Ashok Muralidaran ◽

Frank C. Detterbeck ◽

Daniel J. Boffa ◽

Zuoheng Wang ◽

Anthony W. Kim

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Lung Resection ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Long Term Survival

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DIFFUSION LUNG CAPACITY FOR CARBON MONOXIDE (DLCO) IS AN INDEPENDENT PREDICTOR FOR LONG-TERM SURVIVAL AFTER CURATIVE LUNG RESECTION FOR LUNG CANCER

CHEST Journal ◽

10.1378/chest.134.4_meetingabstracts.s36002 ◽

2008 ◽

Vol 134 (4) ◽

pp. 36S

Author(s):

Michael J. Liptay ◽

Sanjib Basu ◽

Michael C. Hoaglin ◽

Neil Freedman ◽

L.P. Faber ◽

...

Keyword(s):

Lung Cancer ◽

Carbon Monoxide ◽

Independent Predictor ◽

Lung Resection ◽

Term Survival ◽

Long Term Survival ◽

Lung Capacity

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404: Twenty-five years of heart transplantation at a single centre: Changes in factors influencing short- and long-term survival over time

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2006.11.426 ◽

2007 ◽

Vol 26 (2) ◽

pp. S205 ◽

Cited By ~ 1

Author(s):

K. Goldsmith ◽

L. Sharples ◽

C. Sudarshan ◽

J. Parameshwar ◽

S. Tsui ◽

...

Keyword(s):

Heart Transplantation ◽

Single Centre ◽

Term Survival ◽

Long Term Survival ◽

Factors Influencing ◽

Short And Long Term ◽

Over Time

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Impact of diabetes mellitus on long-term survival after transcatheter mitral valve edge-to-edge repair

European Heart Journal ◽

10.1093/eurheartj/ehab724.1640 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

M Geyer ◽

V H Schmitt ◽

K Keller ◽

S Born ◽

K Bachmann ◽

...

Keyword(s):

Diabetes Mellitus ◽

Mitral Valve ◽

Cox Regression ◽

Regression Analyses ◽

Term Survival ◽

Long Term Survival ◽

Short And Long Term ◽

Artery Disease

Abstract Introduction Diabetes mellitus (DM) represents a notable risk factor after surgical and interventional procedures but data on the influence of DM on long-term survival after Transcatheter Edge-to-edge Repair (TEER) for Mitral valve Regurgitation (MR) are sparse. Purpose To compare the outcome of patients with and without DM after TEER. Methods Retrospective monocentric assessment of patients after successful treatment of MR by TEER (exclusion of combined forms of transcatheter repair) between 06/2010 and 03/2018. Patients were stratified for DM at baseline and observed regarding mortality during follow-up. Cox regression analyses were performed for survival analyses. Results 627 patients (47.0% females, 88.2% aged ≥70 years) and among these 174 subjects with DM (27.3%) were included with a median follow-up period of 486 days [IQR 157–916 days]). Within the investigation period, 20 patients (3.2%) were lost to follow-up. Patients with DM more often presented severe comorbidities like obesity (27.3% vs. 9.2%, p<0.001), arterial hypertension (91.4% vs. 83.7%, p=0.013), renal insufficiency (63.8% vs. 43.9%, p<0.001), coronary artery disease (77.0% vs. 59.8%, p<0.001) or peripheral artery disease (14.4% vs. 8.4%, p=0.026) and had a higher median logistic Euroscore I (29.4% [20.0/43.0] vs. 25.0% [16.7/36.6], p=0.001) as well as reduced systolic function (LVEF 35% [30/50] vs. 45% [30/55], p<0.001). No statistical differences in short- and long-term survival were detected between patients with and without DM (in-hospital mortality 1.7 vs. 2.6%, p=0.771; at 30-days 5.0 vs. 6.0%, p=0.842, 1-year 28.7 vs. 25.0%, p=0.419, 3-years 49.2 vs. 44.1%, p=0.554, 5-years 69.0 vs. 68.3%, p=0.497). By calculating cox regression analyses, DM was not predictive for a higher mortality, even after adjustment for other risk factors (HR 1-year 1.17 [95% CI 0.80–1.71], p=0.419; HR long-term 1.13 [95% CI 0.86–1.49], p=0.373) in the total cohort, as well as after stratification for the underlying mitral valve pathology (functional MR: 1-year HR 0.99 [95% CI 0.01–1.62], p=0.969, long-term HR 0.903 [95% CI 0.63–1.29, p=0.571; primary MR: 1-year HR 1.48 [95% CI 0.66–3.35, p=0.344, long-term HR1.66 [95% CI 0.89–3.09], p=0.110). Conclusions Even though DM-patients presented with a more vulnerable clinical profile, no relevant differences in short- and long-term mortality after TEER for MR were found. Although being factored in most common risk scores, DM could not be associated with an adverse prognosis after transcatheter therapy of MR. FUNDunding Acknowledgement Type of funding sources: None.

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Validation of the 8th lung cancer TNM classification and clinical staging system in a German cohort of surgically resected patients

Innovative Surgical Sciences ◽

10.1515/iss-2020-0010 ◽

2020 ◽

Vol 5 (1-2) ◽

pp. 1-9

Author(s):

Samantha Taber ◽

Joachim Pfannschmidt

Keyword(s):

Lung Cancer ◽

Tnm Classification ◽

Clinical Staging ◽

Term Survival ◽

Long Term Survival ◽

7Th Edition ◽

Tumor Stages ◽

8Th Edition

AbstractObjectivesThe updated 8th edition of the tumor, node, metastases (TNM) classification system for non-small cell lung cancer (NSCLC) attempts to improve on the previous 7th edition in predicting outcomes and guiding management decisions. This study sought to determine whether the 8th edition was more accurate in predicting long-term survival in a European population of surgically treated NSCLC patients.MethodsWe scanned the archives of the Heckeshorn Lung Clinic for patients with preoperative clinical stages of IIIA or lower (based on the 7th edition), who received surgery for NSCLC between 2009 and 2014. We used pathologists’ reports and data on tumor size and location to reassign tumor stages according to the 8th edition. We then analyzed stage specific survival and compared the accuracy of the two systems in predicting long-term survival. We excluded patients with neoadjuvant treatment, incomplete follow-up data, tumor histologies other than NSCLC, or death within 30 days of surgery.ResultsThe final analysis included 1,013 patients. Overall five-year survival was 47.3%. The median overall survival (OS) was 63 months (range 1–222), and the median disease-free survival (DFS) was 50 months (0–122). The median follow-up time for non-censored patients was 84 months (range 60–122).ConclusionsWe found significant survival differences between the newly defined stages 1A1, 1A2 and 1A3 (previously 1A). We also found that the 8th edition of TMN classification was a significantly better predictor of long-term survival, compared to the 7th edition.

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