Pulmonary Complications of Combined Chemotherapy and Radiotherapy in Lung Cancer

2015 ◽  
pp. 136-144 ◽  
Author(s):  
Paul Y. M. Chan ◽  
A. Robert Kagan ◽  
John E. Byfield ◽  
Aroor A. Rao ◽  
Harvey A. Gilbert ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Complications ◽  
Combined Chemotherapy

Unplanned readmission and survival after video-assisted thoracic surgery and open thoracotomy in patients with non-small-cell lung cancer: a 12-month nationwide cohort study

2020 ◽  
Author(s):  
Ilies Bouabdallah ◽  
Vanessa Pauly ◽  
Marie Viprey ◽  
Veronica Orleans ◽  
Guillaume Fond ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
Thoracic Surgery ◽  
Small Cell Lung Cancer ◽  
Pulmonary Complications ◽  
Small Cell ◽  
Unplanned Readmission ◽  
Open Thoracotomy ◽  
Small Cell Lung

Abstract OBJECTIVES To compare outcomes at 12 months between video-assisted thoracic surgery (VATS) and open thoracotomy (OT) in patients with non-small-cell lung cancer (NSCLC) using real-world evidence. METHODS We did a nationwide propensity-matched cohort study. We included all patients who had a diagnosis of NSCLC and who benefitted from lobectomy between 1 January 2015 and 31 December 2017. We divided this population into 2 groups (VATS and OT) and matched them using propensity scores based on patients’ and hospitals’ characteristics. Unplanned readmission, mortality, complications, length of stay and hospitalization costs within 12 months of follow-up were compared between the 2 groups. RESULTS A total of 13 027 patients from 180 hospitals were included, split into 6231 VATS (47.8%) and 6796 OT (52.2%). After propensity score matching (5617 patients in each group), VATS was not associated with a lower risk of unplanned readmission compared with OT [20.7% vs 21.9%, hazard ratio 1.03 (0.95–1.12)] during the 12-months follow-up. Unplanned readmissions at 90 days were mainly due to pulmonary complications (particularly pleural effusion and pneumonia) and were associated with higher mortality at 12 months (13.4% vs 2.7%, P < 0.0001). CONCLUSIONS VATS and OT were both associated with high incidence of unplanned readmissions within 12 months, requiring a better identification of prognosticators of unplanned readmissions. Our study highlights the need to improve prevention, early diagnosis and treatment of pulmonary complications in patients with VATS and OT after discharge. These findings call for improving the dissemination of systematic perioperative care pathway including efficient pulmonary physiotherapy and rehabilitation.

scholarly journals Prediction of Postoperative Pulmonary Complications Using Preoperative Controlling Nutritional Status (CONUT) Score in Patient with Resectable Non-small Cell Lung Cancer (P12-032-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ah Young Leem ◽  
Ji Ye Jung ◽  
Sang Chul Lee ◽  
Eun Young Kim ◽  
Sang Hoon Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Nutritional Status ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pulmonary Complications ◽  
Small Cell ◽  
Postoperative Pulmonary Complications ◽  
Small Cell Lung ◽  
Prolonged Air Leak ◽  
Conut Score

Abstract Objectives Postoperative pulmonary complications (PPCs) significantly impact surgical outcome, but the clinical usefulness of various models used to predict PPCs is questionable. The controlling nutritional status (CONUT) score reflects nutritional deficiency and inflammation and is used to predict clinical outcomes in various malignancies. We aimed to investigate the ability of the CONUT score to predict PPCs after lung resection in patients with non-small cell lung cancer (NSCLC). Methods We retrospectively reviewed data of 922 patients with NSCLC who underwent complete resection at Severance Hospital in South Korea during January 2016–December 2017. We analyzed the predictability of the CONUT score for PPCs compared with other inflammatory prognostic markers and PPCs risk scoring systems (prognostic nutritional index [PNI], Glasgow prognostic score [GPS], and assessment of respiratory risk in surgical patients in Catalonia [ARISCAT] score) using receiver operating characteristic curves analysis. Results Of 922 study subjects, 522 (56.6%) were male; the mean age was 64.2 years. Lobectomy was the most common type of operation (n = 737, 79.9%). Total incidence of PPCs was 8.6% (n = 79). Prolonged air leak (44.3%) was the most common PPC, followed by pneumonia (32.9%) and pneumothorax (11.4%). The proportion of pneumonia was significantly larger in the high CONUT group (P < 0.05). The CONUT consistently had a higher area under curve (AUC) value (0.64) than other prognostic models (PNI: AUC = 0.61, GPS: AUC = 0.57, and ARISCAT: AUC = 0.54). Multivariate analysis identified male sex (odds ratio [OR] = 1.94), low body mass index (OR = 4.57), and high CONUT score (OR = 1.91) as independent PPCs prognostic factors. Kaplan-Meier analysis revealed a significantly higher 1-year mortality rate for the high CONUT group (hazard ratio = 7.97; 95% confidence interval, 1.78–35.59). Conclusions Preoperative CONUT score is an independent predictor of PPCs and 1-year mortality in patients with NSCLC. Funding Sources None.

scholarly journals Impact of diffusing lung capacity before and after neoadjuvant concurrent chemoradiation on postoperative pulmonary complications among patients with stage IIIA/N2 non-small-cell lung cancer

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sumin Shin ◽  
Yong Soo Choi ◽  
Jae Jun Jung ◽  
Yunjoo Im ◽  
Sun Hye Shin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pulmonary Complications ◽  
Small Cell ◽  
Postoperative Pulmonary Complication ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Before And After ◽  
The Impact

Abstract Background and objective This study aims to evaluate the impact of diffusing capacity of the lung for carbon monoxide (DLco) before and after neoadjuvant concurrent chemoradiotherapy (CCRT) on postoperative pulmonary complication (PPC) among stage IIIA/N2 non-small-cell lung cancer (NSCLC) patients. Methods We retrospectively studied 324 patients with stage IIIA/N2 NSCLC between 2009 and 2016. Patients were classified into 4 groups according to DLco before and after neoadjuvant CCRT; normal-to-normal (NN), normal-to-low (NL), low-to-low (LL), and low-to-very low (LVL). Low DLco and very low DLco were defined as DLco < 80% predicted and DLco < 60% predicted, respectively. Results On average, DLco was decreased by 12.3% (±10.5) after CCRT. In multivariable-adjusted analyses, the incidence rate ratio (IRR) for any PPC comparing patients with low DLco to those with normal DLco before CCRT was 2.14 (95% confidence interval (CI) = 1.36–3.36). Moreover, the IRR for any PPC was 3.78 (95% CI = 1.68–8.49) in LVL group compared to NN group. The significant change of DLco after neoadjuvant CCRT had an additional impact on PPC, particularly after bilobectomy or pneumonectomy with low baseline DLco. Conclusions The DLco before CCRT was significantly associated with risk of PPC, and repeated test of DLco after CCRT would be helpful for risk assessment, particularly in patients with low DLco before neoadjuvant CCRT.

Combined chemotherapy with AVP (Nidran + Vepasid + Cisplatin) in patients with extensive lung cancer

Lung Cancer ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 37-38
Author(s):  
M.B Bychkov ◽  
V.A Gorbunova ◽  
A.F Marenich ◽  
D.R Naschletashvili
Keyword(s):  
Lung Cancer ◽  
Combined Chemotherapy
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