scholarly journals Analysis of Risk Factors for Postoperative Complications in Non-Small Cell Lung Cancer: Comparison With The Japanese National Clinical Database Risk Calculator

2021 ◽  
Author(s):  
Nozomu Motono ◽  
Masahito Ishikawa ◽  
Shun Iwai ◽  
Aika Yamagata ◽  
Yoshihito Iijima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Morbidity ◽  
Pulmonary Resection ◽  
Operative Procedure ◽  
Significant Risk ◽  
Small Cell ◽  
Risk Calculator ◽  
Clinical Database ◽  
Small Cell Lung ◽  
National Clinical Database

Abstract Background: Although the risk calculator of the National Clinical Database (RC-NCD) has been widely used to predict the occurrence of mortality and major morbidity in Japan, it has not been demonstrated whether a correlation between the calculated RC-NCD risk score and the actual occurrence of mortality and severe morbidity exists.Methods: The clinical data of 739 patients who underwent pulmonary resection for non-small cell lung cancer were collected, and the risk factors for postoperative morbidity were analyzed to verify the validity of the RC-NCD.Results: The coexistence of asthma (p=0.02), smoking status (p=0.04), forced expiratory volume % in one second (p=0.02), pulmonary lobe (p<0.01), and type of operative procedure (p<0.01) were significant risk factors for postoperative morbidity in the present study, and the body mass index (BMI) (p<0.01) and type of operative procedure (p<0.01) were significant risk factors for severe postoperative morbidity. Furthermore, in patients received lobectomy, coexistence of asthma (p=0.01) and pulmonary lobe (p<0.01) were identified as significant risk factors for postoperative morbidity. Meanwhile, male sex (p=0.01), high BMI (p<0.01),　low vital capacity (p=0.04), and pulmonary lobe (p=0.03) were identified as significant risk factors for severe postoperative morbidity.Conclusions: Given that the pulmonary lobe was a significant risk factor for postoperative morbidity in patients received pulmonary resection and for severe postoperative morbidity in patients received lobectomy, the RC-NCD for postoperative morbidity needs to be modified according to high-risk lobes.Trial registration: The Institutional Review Board of Kanazawa Medical University approved the protocol of this retrospective study (approval number: I392), and written informed consent was obtained from all patients.

Surgical Outcomes of Non-Small Cell Lung Cancer in Single-Zone N2 in the Aortopulmonary Zone

2021 ◽  
Author(s):  
Kanghoon Lee ◽  
Yong Ho Jeong ◽  
Jin-Sook Ryu ◽  
Yong-Il Kim ◽  
Hyeong Ryul Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Significant Risk ◽  
Small Cell ◽  
Small Cell Lung

Abstract Objectives We evaluate the surgical outcome of clinically single-zone N2 lung cancer limited to aortopulmonary zone (AP zone; lymph node #5 or #6). Patients and Methods We performed a retrospective analysis of patients with non-small cell lung cancer, in whom mediastinal lymph node metastasis was confined to AP zone. Results A total of 84 patients who underwent upfront surgery were included in final analysis. Among these patients, pathological nodal outcomes were pN0–1 in 27 patients (32.1%), pN2a in 31 (36.9%), and pN2b in 26 (31.0%). In multivariate analysis, adenocarcinoma (p = 0.005) and staging workup without endobronchial ultrasound-transbronchial needle aspiration (p = 0.002) were independent risk factors for unexpected pN2b. The 5-year overall survival (OS) and disease-free survival (DFS) were 55.9 and 54.4%, respectively. There was no survival difference among patients with pN0–1, pN2a, and pN2b (p = 0.717). In survival analysis, there were no significant risk factors for OS. However, female sex and the ratio of positive lymph nodes to removed lymph nodes were significant risk factors for DFS in multivariate analysis (p = 0.032 and p = 0.009). Conclusion In this study, cN2a in the AP zone with current diagnostic tool exhibited a relatively high false-positive rate (cN2/pN0–1; 32.1%). However, despite the possibility of pN2b, there were no significant differences in survival outcome according to the pathologic nodal stage.

Varying recurrence rates and risk factors associated with different definitions of local recurrence in patients with surgically resected stage I non-small cell lung cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7583-7583
Author(s):  
L. N. Medford-Davis ◽  
J. Varlotto ◽  
A. Recht ◽  
J. C. Flickinger ◽  
M. M. DeCamp
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Local Recurrence ◽  
Small Cell Lung Cancer ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Significant Risk ◽  
Small Cell ◽  
Small Cell Lung ◽  
Distant Failure

7583 Background: To examine the effects of different definitions of local recurrence on the reported patterns of failure and associated risk factors in patients undergoing potentially curative resection of Stage I non-small cell lung cancer (NSCLC). Methods: The study included 306 consecutive patients treated from 2000–2005 without radiotherapy. Local recurrence was defined as either: “radiation” (i.e., recurrences confined to the post-operative radiotherapy fields used in the Phase III trial of adjuvant radiotherapy by Trodella et al) (LRR), including the bronchial stump, staple line, the ipsilateral hilum, and ipsilateral mediastinum; or “comprehensive” (LRC), including these sites plus the ipsilateral lung and contralateral mediastinal and hilar nodes. Results: The median follow-up was 33 months. Proportions of LRC and LRR at 2, 3 and 5 years were 14%, 21% and 29%; and 7%, 12%, and 16%, respectively. Significant risk factors for LRC on multivariable analysis were diabetes, lymphatic vascular invasion and tumor size; significant factors for LRR were resection of less than a lobe and lymphatic vascular invasion. Distant (non-local) relapse proportions using these definitions at 2, 3 and 5 years were 10%, 12%, and 18%; and 14%, 19%, and 29%, respectively. Significant risk factors for distant failure were histology when using the LRC definitions and tumor size using the LRR definition. Conclusions: Local recurrence increased nearly two-fold when a broad definition was used, rather than a narrow one. The definition also affected which factors were significantly associated with both local and distant failure on multivariate analysis. Comparable definitions must be used when analyzing different series. No significant financial relationships to disclose.

Clinical characteristics of nivolumab-induced radiation recall pneumonitis in patients with non-small cell lung cancer: A multicenter real-world analysis of 669 patients.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 88-88 ◽  
Author(s):  
Tadasuke Shimokawaji ◽  
Shoko Narita ◽  
Tomoyuki Naito ◽  
Hibiki Udagawa ◽  
Koichi Goto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Clinical Characteristics ◽  
Significant Risk ◽  
Small Cell ◽  
Small Cell Lung ◽  
Radiation Recall ◽  
Lung Cancer Patients ◽  
History Of ◽  
Recall Pneumonitis

88 Background: Immune checkpoint inhibitors can cause immune-related pneumonitis in lung cancer patients. Some of those patients with history of previous thoracic radiation therapy (TRT) are reported to show radiation recall pneumonitis (RRP) pattern. In this multicenter retrospective study, we analyzed the patient background and clinical characteristics of RRP. Methods: Medical records of non-small cell lung cancer patients, who received nivolumab between December 2015 and March 2017, were retrospectively reviewed. Incidence of pneumonitis, and incidence, risk factors and clinical characteristics of RRP were analyzed at 5 institutions. Person’s chi-square test (age, sex, smoking history, performance status at the start of nivolumab treatment, background lung disease, history of previous radiation pneumonitis, total dose, volume receiving more than 20Gy, 30Gy, mean lung dose of TRT, and duration after TRT) was conducted to identify potential risk factors of RRP. RRP was defined as fibrosis or consolidation occurring in the previous TRT field, and imaging analysis was conducted by two individual radiologists. Results: A total of 669 patients were evaluated, and the incidences of all-grade and ≥ grade 3 pneumonitis were 8.8% (59/669) and 6.2% (18/669), respectively. Incidence of RRP was 5.4% (14/257) among patients with history of previous TRT. There were no significant risk factors for RRP. Although we did not find significant difference between the severity of RRP pattern and other radiological patterns of pneumonitis, patients with RRP showed better outcome. All patients recovered from RRP without no exacerbation or death, compared to 9.3% of exacerbation or death in other patterns of pneumonitis. Conclusions: Incidence of RRP was 5.4% among patients with history of previous TRT, although there were no significant risk factors of RRP. Patients with RRP pattern showed relatively better outcome.

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