EP1.18-04 Do Tumor-Related Factors Predict Postoperative Pulmonary Complications in Patients Undergoing Curative Surgery for Lung Cancer?

Abstract

The purpose of the present study is to identify preoperative risk factors related to pulmonary complications with a focus on tumor-related factors. The authors conducted a retrospective review of the clinical records of all patients operated at the thoracic department of the Lviv State Oncological Regional Treatment and Diagnostic Center in 2010-2011. Tumor-related factors (histological type of lung cancer, tumor localization, TNM classification, past medical history of different cancer types) were analyzed. Postoperative pulmonary morbidity was defined as: respiratory failure, atelectasis, air leak more than 7 days, prolonged intubation (>72hours), pleural effusion, pleural empyema, chylothorax, and pneumothorax. The study included patients meeting the following criteria: age under 70, absence of neoadjuvant chemo- and/or radiotherapy, benign lung lesions, lung metastases, and non-curative lung resection. Logistic regression was performed using IBM SPSS Statistics 22 program. The result was considered statistically significant when p<0.05. 144 patients underwent surgery for primary lung cancer at our institution. Lobectomy was performed in 36.1%, pneumonectomy – in 59%, lung resection – in 4.9% of patients. Histological examination showed that 84 patients had squamous cell carcinoma, 31 patients – adenocarcinoma, 6 patients – large cell carcinoma, 6 patients – small cell carcinoma, 8 patients – NET and 9 patients – other histological types. 12 (8.3%) patients had a medical history of a different type of cancer. The 30-day postoperative mortality rate was 3.47%, postoperative morbidity was 36.8%. The analysis showed that presence of a different type of cancer in past medical history (p<0.05) remained a significant risk factor for respiratory morbidity after lung cancer surgery while the presence of NET reduces the risk of postoperative pulmonary complications (p<0.05). Presence of a different type of cancer in past medical history constitutes a significant risk factor for respiratory postoperative morbidity in lung cancer patients. Patients with NET have a lower risk of postoperative pulmonary complications. We suggest that this result requires confirmation by further research.