The time trends of gallbladder cancer and cholangiocarcinoma in 1,047 patients.

376 Background: Gallbladder cancer (Gb ca) and cholangiocarcinoma (CC ca) are major primary sites in biliary tract cancer. Progresses of diagnosis and anti-cancer therapy for Gb and CC ca lead to the changes of patients’ characteristics and overall survival time, but is not fully understood. This study aimed to identify the time trends in patients with Gb and CC ca. Methods: The inclusive criteria in this study was the patients receiving initial treatment including surgery (Op), chemotherapy (Chemo), radiotherapy (RT), or best supportive care (BSC) for Gb or CC ca in our institution, and 1047 patients were reviewed. Patient who received initial treatment at 1992-2005 were in 54.1 % of the study subjects and was defined as Group 1. Patients with initial treatment at 2006-2012 were categorized to Group 2 and were in 45.9% of all patients. The differences between two groups were evaluated, and the features of Group 2 were identified. Results: Age more than 60 years (Odd ratio [OR]: 2.37), the absence of distant metastasis (OR: 2.13), and ECOG performance status score (PS) = 0 (OR: 1.70) were identified as the independent features of Group 2. The rates of Op, Chemo, RT, and BSC were 38.5, 24.7, 14.9, and 21.7% in Group 1, and 40.8, 49.9, 1.5, and 6.0% in Group 2. The rate of Chemo in Group 2 was higher than that in Group 1 (P < 0.01). The median times of overall survival (OS) in Op, Chemo, RT, and BSC were 21.1, 5.2, 6.9, and 2.4 months in Group 1 and 60.6, 9.2, 10.5, 2.8 months in Group 2. The OS in Op or Chemo of Group 2 was longer than that in Group 1 (P < 0.01, P < 0.01). The independent poor prognostic factors were distant metastasis (HR: 3.91), Group 1 (1.81), and PS > 0 (1.72) in all patients, distant metastasis (HR: 3.56), Group 1 (2.12), biliary drainage (1.75) in Op, and PS>0 (HR: 1.97), Group 1 (1.74), and distant metastasis (1.64) in Chemo. Conclusions: The recent trends in patients with Gb and CC ca were aging, low rates of distant metastasis, good PS, increased cases with chemotherapy, and the prolonged survival times in surgery and chemotherapy. The presence of distant metastasis, the worsened PS, and the previous treatment group were the independent poor prognostic factors.

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Examination of Prognostic Factors Affecting Long-Term Survival of Patients with Stage 3/4 Gallbladder Cancer without Distant Metastasis

Cancers ◽

10.3390/cancers12082073 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2073

Author(s):

Ryota Higuchi ◽

Takehisa Yazawa ◽

Shuichirou Uemura ◽

Yutaro Matsunaga ◽

Takehiro Ota ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Gallbladder Cancer ◽

Distant Metastasis ◽

Surgical Outcome ◽

Hepatoduodenal Ligament ◽

Entire Area ◽

Factors Affecting ◽

Left Margin

In advanced gallbladder cancer (GBC) radical resection, if multiple prognostic factors are present, the outcome may be poor; however, the details remain unclear. To investigate the poor prognostic factors affecting long-term surgical outcome, we examined 157 cases of resected stage 3/4 GBC without distant metastasis between 1985 and 2017. Poor prognostic factors for overall survival and treatment outcomes of a number of predictable preoperative poor prognostic factors were evaluated. The surgical mortality was 4.5%. In multivariate analysis, blood loss, poor histology, liver invasion, and ≥4 regional lymph node metastases (LNMs) were independent prognostic factors for poor surgical outcomes; invasion of the left margin or the entire area of the hepatoduodenal ligament and a Clavien–Dindo classification ≥3 were marginal factors. The analysis identified outcomes of patients with factors that could be predicted preoperatively, such as liver invasion ≥5 mm, invasion of the left margin or the entire area of the hepatoduodenal ligament, and ≥4 regional LNMs. Thus, the five-year overall survival was 54% for zero factors, 34% for one factor, and 4% for two factors (p < 0.05). A poor surgical outcome was likely when two or more factors were predicted preoperatively; therefore, new treatment strategies are required for such patients.

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Gamma Knife Stereotactic Radiosurgery for Patients with Glioblastoma Multiforme

Neurosurgery ◽

10.1097/00006123-200201000-00009 ◽

2002 ◽

Vol 50 (1) ◽

pp. 41-47 ◽

Cited By ~ 15

Author(s):

Emmanuel C. Nwokedi ◽

Steven J. DiBiase ◽

Salma Jabbour ◽

Joseph Herman ◽

Pradip Amin ◽

...

Keyword(s):

Overall Survival ◽

Regression Analysis ◽

Glioblastoma Multiforme ◽

Stereotactic Radiosurgery ◽

Cox Regression ◽

Karnofsky Performance Status ◽

Performance Status ◽

Cox Regression Analysis ◽

Group 2 ◽

Group 1

ABSTRACT OBJECTIVE Stereotactic radiosurgery (SRS) has become an effective therapeutic modality for the treatment of patients with glioblastoma multiforme (GBM). This retrospective review evaluates the impact of SRS delivered on a gamma knife (GK) unit as an adjuvant therapy in the management of patients with GBM. METHODS Between August 1993 and December 1998, 82 patients with pathologically confirmed GBM received external beam radiotherapy (EBRT) at the University of Maryland Medical Center. Of these 82 patients, 64 with a minimum follow-up duration of at least 1 month are the focus of this analysis. Of the 64 assessable patients, 33 patients were treated with EBRT alone (Group 1), and 31 patients received both EBRT plus a GK-SRS boost (Group 2). GK-SRS was administered to most patients within 6 weeks of the completion of EBRT. The median EBRT dose was 59.7 Gy (range, 28–70.2 Gy), and the median GK-SRS dose to the prescription volume was 17.1 Gy (range, 10–28 Gy). The median age of the study population was 50.4 years, and the median pretreatment Karnofsky performance status was 80. Patient-, tumor-, and treatment-related variables were analyzed by Cox regression analysis, and survival curves were generated by the Kaplan-Meier product limit. RESULTS Median overall survival for the entire cohort was 16 months, and the actuarial survival rate at 1, 2, and 3 years were 67, 40, and 26%, respectively. When comparing age, Karnofsky performance status, extent of resection, and tumor volume, no statistical differences where discovered between Group 1 versus Group 2. When comparing the overall survival of Group 1 versus Group 2, the median survival was 13 months versus 25 months, respectively (P = 0.034). Age, Karnofsky performance status, and the addition of GK-SRS were all found to be significant predictors of overall survival via Cox regression analysis. No acute Grade 3 or Grade 4 toxicity was encountered. CONCLUSION The addition of a GK-SRS boost in conjunction with surgery and EBRT significantly improved the overall survival time in this retrospective series of patients with GBM. A prospective, randomized validation of the benefit of SRS awaits the results of the recently completed Radiation Therapy Oncology Group's trial RTOG 93-05.

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FOLFIRINOX in patients with peritoneal carcinomatosis from pancreatic adenocarcinoma: a retrospective study

Current Oncology ◽

10.3747/co.26.4903 ◽

2019 ◽

Vol 26 (4) ◽

Cited By ~ 1

Author(s):

E. Bonnet ◽

C. Mastier ◽

A. Lardy-Cléaud ◽

P. Rochefort ◽

M. Sarabi ◽

...

Keyword(s):

Overall Survival ◽

Peritoneal Carcinomatosis ◽

Median Overall Survival ◽

Group Performance ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Poor Prognostic Factor ◽

Group 2 ◽

Ecog Ps ◽

Group 1

Background Peritoneal carcinomatosis (PCM) in metastatic pancreatic ductal adenocarcinomas (mPDAC) is frequently encountered in day-to-day practice, but rarely addressed in the literature. The objective of the present study was to describe the management and outcome of patients diagnosed with PCM.Methods Data for all consecutive patients with mpdac treated in our centre between 1 January 2014 and 31 August 2015 were analyzed retrospectively. Computed tomography imaging was centrally reviewed by a dedicated radiologist to determine the date of pcm diagnosis.Results The analysis included 48 patients. Median age in the group was 61 years, and 41 patients had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–1. All patients presented with pcm either synchronously (group 1) or metachronously (group 2). Those groups differed significantly by baseline ecog ps and neutrophil-tolymphocyte ratio (nlr), with ecog ps being poorer and nlr being higher in group 1. In addition to PCM, the main sites of metastasis were liver (62.5%) and lungs (31.3%). First-line chemotherapy in 36 patients (75%) was FOLFIRINOX (fluorouracil–irinotecan–leucovorin–oxaliplatin). The median overall survival for the entire population was 10.81 months [95% confidence interval (ci): 7.16 months to 14.16 months]; it was 13.17 months (95% ci: 5.9 months to 15.4 months) for patients treated with folfirinox. Median overall survival was 7.13 months (95% ci: 4.24 months to 10.41 months) for patients in group 1 and 14.34 months (95% ci: 9.79 months to 19.91 months) for patients in group 2, p = 0.1296.Conclusions Compared with other metastatic sites, synchronous pcm seems to be a poor prognostic factor. It could be more frequently associated with a poor ECOG PS and a NLR greater than 5 in this group of patients. In patients with mPDAC and PCM, either synchronous or metachronous, FOLFIRINOX remains an efficient regimen.

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Clinical Significance of Microinvasion in Borderline Ovarian Tumors and Its Impact on Surgical Management

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31825e5254 ◽

2012 ◽

Vol 22 (7) ◽

pp. 1158-1162 ◽

Cited By ~ 13

Author(s):

Annamaria Ferrero ◽

Isabella Strada ◽

Barbara Di Marcoberardino ◽

Lucia Ricci Maccarini ◽

Federica Pozzati ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors ◽

Fertility Sparing Surgery ◽

Fertility Sparing ◽

Exophytic Tumor ◽

Group 2 ◽

Group 1

ObjectiveThe aims of this study were to evaluate the rate of recurrences in borderline ovarian tumors (BOTs) with microinvasion and to evaluate the possibility to enlarge fertility-sparing surgery in this group of patients.MethodsBetween 1985 and 2010, 209 patients with BOTs were retrospectively divided into 2 groups: group 1 consisted of 28 women with microinvasive BOTs; group 2 consisted of 181 with BOTs without microinvasion. All of the patients were submitted to surgical treatment: in group 1, 10 patients underwent cystectomy (CYS), 11 patients underwent monolateral salpingo-oophorectomy (MSO), and 7 patients underwent bilateral oophorectomy with or without total hysterectomy (BSO); in group 2, 34 patients underwent CYS, 58 patients underwent MSO, and 89 patients underwent BSO. Specific prognostic factors such as stage, surgical approach, intraoperative spillage, histology, exophytic tumor growth, and endosalpingiosis were analyzed. Tumor recurrence rate and overall and disease-free survivals were evaluated.ResultsAfter a mean follow-up of 53 months, relapses occurred in 21.4% of the cases in group 1 and in 12.7% of the cases in group 2 (P = 0.21). The prognostic factors had no significant differences in the 2 groups. Relapses after CYS, MSO, and BSO were observed in 30%, 27.3%, and 0%, respectively, in group 1 and in 29.4%, 12.1%, and 6.7%, respectively, in group 2. Progression-free survival was significantly longer in BOTs compared to microinvasive BOTs (P = 0.041), but overall survival did not differ.ConclusionsAlthough exploratory, our data suggest that BOTs with microinvasion present earlier relapses, but overall incidence of relapses and overall survival do not differ significantly from BOTs without microinvasion. Fertility-sparing surgery is feasible in this group of patients, but strict follow-up has to be suggested.

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Use of bisphosphonates (Bis) combined with sunitinib (Su) to improve the response rate (RR), progression-free survival (PFS), and overall survival (OS) of patients (pts) with bone metastases (mets) from renal cell carcinoma (RCC).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4619 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4619-4619

Author(s):

Avivit Peer ◽

Maya Ish-Shalom ◽

Hans J. Hammers ◽

Mario A. Eisenberger ◽

Victoria J. Sinibaldi ◽

...

Keyword(s):

Prognostic Factors ◽

Cox Regression ◽

Clear Cell ◽

Performance Status ◽

Objective Response ◽

Partial Likelihood ◽

Elevated Alkaline Phosphatase ◽

Factors Associated ◽

Group 2 ◽

Group 1

4619 Background: Bis are used to prevent skeletal events of bone mets, and may exhibit anti tumor effects. We aimed to evaluate whether Bis can bring a RR, PFS, and OS benefit to pts with bone mets from RCC that are treated with Su. Methods: We performed an international multicenter retrospective study of pts with bone mets from RCC who were treated with Su. Pts were divided into Bis users (group 1) and nonusers (group 2). The effect of Bis on RR, PFS and OS, was tested with adjustment for known prognostic factors using a chisquare test from contingency table and partial likelihood test from Cox regression model. Results: Between 2004-2011, 244 pts with metastatic RCC were treated with Su. 92 pts had bone mets, 41 group 1 and 51 group 2. The groups were balanced regarding the following known prognostic factors: past nephrectomy, clear cell vs non clear cell histology, initial diagnosis to sunitinib treatment (tx) time, presence of ≥ 2 mets sites, presence of lung/liver mets, ECOG performance status, anemia, calcium level > 10 mg/dL, elevated alkaline phosphatase (AP), pre-tx neutrophil to lymphocyte ratio (NLR) >3, sunitinib induced HTN, and the use of angiotensin system inhibitors. They were also balanced with regard to past cytokines/targeted tx, and mean sunitinib dose/cycle. Objective response was partial response/stable disease 85% (n=35) vs 71% (n=36), and progressive disease 15% (n=6) vs 29% (n=15) (OR 3.287, p=0.07) in group 1 vs 2 respectively. Median PFS was 15 vs 5 months (HR 0.433, p=0.035), and median OS not reached with a median folloup time of 43 mos vs 12 months (HR 0.398, p=0.003), in favor of group 1. In multivariate analysis of the entire pt cohort (n=92), factors associated with PFS were Bis use (HR 0.433, p=0.035), pre-tx NLR ≤3 (HR 0.405, p=0.016), and elevated AP (HR=3.63, p=0.012). Factors associated with OS were Bis use (HR 0.32, p=0.003), elevated AP (HR 3.18, p=0.002), and Su induced HTN (HR 0.193, p< 0.001). Conclusions: Bis may improve the outcome of Su tx in RCC with bone mets. This should be investigated prospectively, and if validated applied in clinical practice and clinical trials.

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Etoposide as an Effective Drug for Adult Macrophage Activation Syndrome: A Retrospective Study

10.21203/rs.3.rs-144071/v1 ◽

2021 ◽

Author(s):

Lingbo He ◽

Zhili Jin ◽

Menghan Liu ◽

Tingting Cui ◽

Lin Wu ◽

...

Keyword(s):

Autoimmune Disease ◽

Initial Treatment ◽

Macrophage Activation Syndrome ◽

Macrophage Activation ◽

Hemophagocytic Syndrome ◽

Response Rate ◽

Initial Therapy ◽

Group 2 ◽

Activation Syndrome ◽

Group 1

Abstract BackgroundAutoimmune disease related hemophagocytic syndrome, in other words, macrophage activation syndrome(MAS), is a rare, but lethal complication of autoimmune disease. At present, specific treatment guidelines for adult MAS have not been formulated, most experience are derived from children, researches about etoposide are scarce. As the importance of etoposide in the initial treatment had been proved in other subtypes of hemophagocytic syndrome, the objective of this study is to investigate the effectiveness of etoposide in the treatment of the adult macrophage activation syndrome.Result74 patients with autoimmune disease related hemophagocytic syndrome were involved in this study, they were divided into two groups based on initial treatment, group 1(n=53): initial therapy did not contain etoposide, group 2(n=21): initial therapy contained etoposide. The overall response rate and complete response rate of group 2 were significantly higher than group 1(ORR 90.5% vs 24.5%, CRR 33.3% vs 3.8%, P<0.05). Patients with different HLH remission states have significantly different prognosis(P<0.001).ConclusionAdopting VP-16 in initial treatment can significantly increase the OR rate and CR rate of adult MAS patients, and the HLH states influenced the prognosis significantly.

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Improved Overall Survival and Decreased Metastasis With Adjuvant 5-Fluorouracil and Platinum Chemotherapy After Definitive Concurrent Chemoradiotherapy for N3 Nasopharyngeal Cancer: A Registry-Based Analysis

10.21203/rs.3.rs-228154/v1 ◽

2021 ◽

Author(s):

Mu-Hung Tsai ◽

Shang-Yin Wu ◽

Tsung Yu ◽

Sen-Tien Tsai ◽

Yuan-Hua Wu

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Adjuvant Chemotherapy ◽

Distant Metastasis ◽

Concurrent Chemoradiotherapy ◽

Locally Advanced ◽

Nasopharyngeal Cancer ◽

Disease Free Survival ◽

Free Survival ◽

Risk Of Death

Abstract Background and purpose Concurrent chemoradiotherapy is the established treatment for locally advanced nasopharyngeal carcinoma (NPC). However, there is no evidence supporting routine adjuvant chemotherapy. We aimed to demonstrate the effect of adjuvant chemotherapy on survival and distant metastasis in high-risk N3 NPC patients. Materials and methods We linked the Taiwan Cancer Registry and Cause of Death database to obtain data. Clinical N3 NPC patients were divided as those receiving definitive concurrent chemoradiotherapy (CCRT) with adjuvant 5-fluorouracil and platinum (PF) chemotherapy and those receiving no chemotherapy after CCRT. Patients receiving neoadjuvant chemotherapy were excluded. We compared overall survival, disease-free survival, local control, and distant metastasis in both groups using Cox proportional hazards regression analysis. Results We included 431 patients (152 and 279 patients in the adjuvant PF and observation groups, respectively). Median follow-up was 4.3 years. The 5-year overall survival were 69.1% and 57.4% in the adjuvant PF chemotherapy and observation groups, respectively (p = 0.02). Adjuvant PF chemotherapy was associated with a lower risk of death (hazard ratio [HR] = 0.61, 95% confidence interval [CI]: 0.43–0.84; p = 0.003), even after adjusting for baseline prognostic factors (HR = 0.61, 95% CI: 0.43–0.86; p = 0.005). Distant metastasis-free survival at 12 months was higher in the adjuvant PF chemotherapy group than in the observation group (98% vs 84.8%; p < 0.001). After adjusting for baseline prognostic factors, adjuvant PF chemotherapy was associated with freedom from distant metastasis (HR = 0.11, 95% CI: 0.02–0.46; p = 0.003). Conclusion Prospective evaluation of adjuvant PF chemotherapy in N3 NPC patients treated with definitive CCRT is warranted because adjuvant PF chemotherapy was associated with improved overall survival and decreased risk of distant metastasis.

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Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value

Digestive Surgery ◽

10.1159/000506628 ◽

2020 ◽

Vol 37 (5) ◽

pp. 390-400

Author(s):

Yusuke Yamamoto ◽

Teiichi Sugiura ◽

Yukiyasu Okamura ◽

Takaaki Ito ◽

Ryo Ashida ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Prognostic Factor ◽

Gallbladder Cancer ◽

Major Hepatectomy ◽

Carbohydrate Antigen ◽

Clinical Impact ◽

Surgical Indication ◽

Cutoff Value ◽

Advanced Gallbladder Cancer

Background: Selecting patients who will benefit from resection among those with advanced gallbladder cancer (GBCa) having poor prognostic factors is difficult. Methods: One hundred twenty-one patients who underwent resection for stage II–IV GBCa and 19 unresected patients (unresectable group) were enrolled. The clinical impact of carbohydrate antigen 19-9 (CA19-9) and advanced surgical procedures for GBCa was evaluated. Results: The optimal CA19-9 cutoff value (based on the greatest difference in overall survival) was 250 U/mL. CA19-9 ≥250 U/mL was found to be an independent prognostic factor. Patients with CA19-9 <250 U/mL who developed jaundice (median survival time [MST], 49.1 months) or who required major hepatectomy (MST, 21.5 months) or pancreatoduodenectomy (PD; MST, 50.3 months) had a better prognosis than those with CA19-9 ≥250 U/mL who developed jaundice (MST, 16.1 months; p = 0.061) or who required major hepatectomy (MST, 9.2 months; p = 0.066) or PD (MST, 8.6 months; p = 0.025); their prognosis was comparable to that of the unresectable group (jaundice: p = 0.145, major hepatectomy: p = 0.292, PD: p = 0.756). Conclusions: Even if GBCa patients develop jaundice or require major hepatectomy, or combined PD, resection can be considered for those with CA19-9 <250 U/mL. However, surgical indication should be carefully determined in patients with CA19-9 ≥250 U/mL.

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Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables

Scientific Reports ◽

10.1038/s41598-019-53606-3 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Alejandra Ivars Rubio ◽

Juan Carlos Yufera ◽

Pilar de la Morena ◽

Ana Fernández Sánchez ◽

Esther Navarro Manzano ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Metastatic Breast Cancer ◽

Performance Status ◽

Univariate Analysis ◽

Metastatic Breast ◽

Prognostic Impact ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

AbstractThe prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.

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Staged management of cardiac disease and concomitant early lung cancer: a 20-year single-center experience

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa360 ◽

2020 ◽

Author(s):

Jérémy Tricard ◽

Daniel Milad ◽

Anaëlle Chermat ◽

Serge Simard ◽

Yves Lacasse ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Overall Survival ◽

Disease Free Survival ◽

Free Survival ◽

Cardiac Procedure ◽

Independent Risk Factors ◽

Group 2 ◽

Disease Free ◽

Group 1

Abstract OBJECTIVES The association of unstable heart disease and resectable lung cancer is rare. The impacts of staged management, cardiac surgery with cardiopulmonary bypass (CPB) versus angioplasty, on long-term survival and cancer recurrence remain debated. We report our experience using staged management. METHODS From 1997 to 2016, 107 patients were treated at the Quebec Heart and Lung Institute: 72 underwent cardiac surgery with CPB (group 1), 35 were treated with angioplasty (group 2), followed by oncological pulmonary resection. RESULTS Two postoperative deaths (3%) and 1 ischaemic heart complication (1%) were reported in group 1. One death (3%) was reported in group 2. Two-year overall survival was 82% (59/72) in group 1 and 80% (28/35) in group 2; 5-year overall survival was 62% (33/53) in group 1 and 63% (19/30) in group 2. Two-year disease-free survival in group 1 was 79% (57/72) and 77% (27/35) in group 2; 5-year disease-free survival was 58% (31/53) in group 1 and 60% (18/30) in group 2. The independent risk factors for death after thoracic surgery were transfusions (P = 0.004) and grade ≥3 complications (P = 0.034). Independent risk factors for recurrence included the cancer stage (P < 0.001) and, paradoxically, a shorter delay between cardiac and lung procedures (P = 0.031). CONCLUSIONS When a staged management remains feasible after cardiac procedure, oncological outcomes of patients with cardiopathy and lung cancer are satisfactory. CPB does not seem to be deleterious. The delay between procedures should intuitively be as small as possible but not at the expense of good recovery after the cardiac procedure.

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