Skip to main content
SpringerLink
Log in

Tumor stage and early mortality for surgical resections in lung cancer

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

Postoperative mortality rates have been published in relation to operative procedure or preexisting pulmonary and extrapulmonary diseases. We analyzed our patients for the effect of the postoperative tumor stage on perioperative mortality.

Patients and methods

Retrospective study of all thoracotomies for resections (n=1281) in primary lung cancer from January 1987 to December 1997. Uni- and multivariate analysis was performed for operative procedure, mortality (30 and 90 days), tumor stage, sex, age, tumor localization, and completeness of resection. Radical resection was achieved in 91.9% of the patients.

Results

Overall postoperative deaths occurred in 4% and 7.3% of patients after 30 and 90 days respectively. Depending on the operative procedure the mortality after segmental resection (n=116) was 0.9% and 1.7%, lobectomy (n=621) 3.0% and 5.7%, sleeve lobectomy (n=152) 5.3% and 7.9%, and pneumonectomy (n=314) 6.7% and 12.5%, respectively. Within 30 and 90 days postoperatively deaths occurred, respectively, in 0.8% and 1.0% of stage I patients (n=493), 5.4% and 5.4% of stage II (n=147), 4.9% and 8.8% of stage IIIa (n=388), 7.2% and 16.6% of stage IIIb (n=148), 8.9% and 20.5% and of stage IV (n=114). Multivariate analysis showed postoperative tumor stage to be the factor most closely related to within the first 90 days.

Conclusions

Tumor stage but not type of resection is the strongest predictor of postoperative mortality in these subpopulations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Wilkins EW, Scanell JG, Craver JG (1978) Four decades of experience with resections for bronchogenic carcinoma at the Massachusetts General Hospital. J Thorac Cardiovasc Surg 76:364–368

    PubMed  Google Scholar 

  2. Wada H, Nakamura T, Nakamoto K, Maeda M, Watanabe Y (1998) Thirty-day operative mortality for thoracotomy in lung cancer. J Thorac Cardiovasc Surg 115:70–73

    PubMed  Google Scholar 

  3. Ginsberg RJ, Hill LD, Eagan RT, Thomas P, Mountain CF, Deslauriers J, Fry WA, Butz RO, Goldberg M, Waters PF, Jones DP, Pairolero P, Rubinstein L, Pearson F (1983) Modern thirty-day operative mortality for surgical resections in lung cancer. J Thorac Cardiovasc Surg 86:654–658

    PubMed  Google Scholar 

  4. Ferguson MK, Karrison T (2000) Does pneumonectomy for lung cancer adversely influence long-term-survival. J Thorac Cardiovasc Surg 119:440–448

    PubMed  Google Scholar 

  5. Romano PS, Mark DH (1992) Patient and hospital characteristics related to in-hospital mortality after lung cancer resection. Chest 101:1332–1337

    PubMed  Google Scholar 

  6. Markos J, Mullan B, Hillman DR, Musk AW, Antico VF, Lovegrove T, Carter MJ, Finucane KE (1989) Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis 139:902–910

    PubMed  Google Scholar 

  7. International Union Against Cancer (1987) TNM classification of malignant tumours, 4th edn. Springer, Berlin Heidelberg New York

  8. Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Google Scholar 

  9. Cox D (1972) Regression models and life tables. J R Stat Soc B 34:187–220

    Google Scholar 

  10. Rens MTM, Rivière AB, Elbers HRJ, et al (2000) Prognostic assessment of 2361 patients who underwent pulmonary resection for non small cell lung cancer, stage I, II, IIIa. Chest 117:374–379

    PubMed  Google Scholar 

  11. Stanulla H, Wilde J (1977) Analyse postoperativer Todesfälle nach Lungenresektion wegen Bronchialkarzinom. Z Chir 102:624–628

    CAS  Google Scholar 

  12. Duque JL, Ramos G, Castrodeza J, Cerezal J, Castaneda M, Yuste MG, Heras F, Grupo Cooperativo de Carcinoma Broncogenico de la Sociedad Espanola de Neumologia y Cirugia Toracica (1997) Early complications in surgical treatment of lung cancer: a prospective multicenter study. Ann Thorac Surg 63:944–950

    Article  PubMed  Google Scholar 

  13. Goldstraw P (2000) Age does not influence early and late tumor-related outcome after surgery for bronchogenic carcinoma. Ann Thorac Surg 69:678–679

    Article  PubMed  Google Scholar 

  14. Nagasaki F, Flehinger BJ, Martini N (1982) Complications of surgery in the treatment of carcinoma of the lung. Chest 82:25–29

    PubMed  Google Scholar 

  15. Bernet F, Brodbeck R, Guenin MO, Schüpfer G, Habicht JM, Stulz PM, Carrel TP (2000) Age does not influence early and late tumor-related outcome after surgery for bronchogenic carcinoma. Ann Thorac Surg 69:913–918

    CAS  PubMed  Google Scholar 

  16. Damhuis RAM, Schütte PR (1996) Resection rates and postoperative mortality in 7899 patients with lung cancer. Eur Respir J 9:7–10

    PubMed  Google Scholar 

  17. O'Rourke MA, Feussner JR, Feigl P, Laszio J (1987) Age trends of lung cancer stage at diagnosis. JAMA 258:921–926

    PubMed  Google Scholar 

  18. Brown J, Eraut D, Trask C, Davison AG (1996) Age and the treatment of lung cancer. Thorax 51:564–568

    CAS  PubMed  Google Scholar 

  19. Deslauriers J, Ginsberg RJ, Piantadosi S, Fournier B (1994) Prospective assessment of 30-day operative Morbidity for surgical resections in lung cancer. Chest 106:329S–330S

    PubMed  Google Scholar 

  20. Martin J, Ginsberg R, Abolhoda A, Bains M, Downey R, Korst R, Weigel T, Kris M, Venkatramam E, Rusch V (2001) Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg 72:1149–1154

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was presented in part at the 15th Annual Meeting of the European Association of Cardiothoracic Surgery, Lisbon, Portugal, 9 September 2001.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, University Hospital, 79106, Freiburg, Germany

    Erich Stoelben, Corinna Ludwig & Joachim Hasse

  2. Institute of Medical Biometry and Informatics, University Hospital, 79106, Freiburg, Germany

    Willi Sauerbrei

Authors
  1. Erich Stoelben
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Willi Sauerbrei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Corinna Ludwig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joachim Hasse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erich Stoelben.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stoelben, E., Sauerbrei, W., Ludwig, C. et al. Tumor stage and early mortality for surgical resections in lung cancer. Langenbecks Arch Surg 388, 116–121 (2003). https://doi.org/10.1007/s00423-003-0354-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-003-0354-x

Keywords

Search

Navigation