Objective

This study aimed to analyze whether comorbidities impact postoperative complication rate or survival after anatomical lung resection for non-small cell lung cancer (NSCLC).

Methods

A retrospective analysis of 1219 patients who underwent NSCLC resection between 2000 and 2015 was performed. Analyzed comorbidities included chronic obstructive lung disease (COPD), hypertension, coronary artery disease (CAD), peripheral artery disease, myocardial infarction history, diabetes mellitus, renal insufficiency and other malignancies.

Results

Most patients (78.9%) had comorbidities, most commonly hypertension (34.1%) followed by COPD (26.4%) and other malignancies (19%). The overall complication rate was 38.6% (26.4% pulmonary; 14.8% cardiac; and 3.0% gastrointestinal). Hypertension (odds ratio (OR) = 1.492, p = 0.031) was associated with more cardiac complications. Heavy smoking (OR = 1.008, p = 0.003) and low body mass index (BMI) (OR = 0.932, p < 0.001) affected the pulmonary complication rate significantly. None of the included comorbidities affected the overall complication rate or the survival negatively. However, the patient characteristics of advanced age (p < 0.001), low BMI (p = 0.008), and low FEV1 (p = 0.008) affected the overall complication rate as well as survival (each p < 0.001).

Conclusion

Advanced age, low BMI, and low FEV1 were predictive of greater complication risk and shorter long-term survival in patients who underwent NSCLC resection. Cardiac complications were associated with hypertension and CAD, whereas pulmonary complications were associated with a high pack year count.

中文翻译：

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术前合并症对手术切除非小细胞肺癌患者术后并发症发生率和结局的影响

客观的

本研究旨在分析合并症是否影响非小细胞肺癌 (NSCLC) 解剖性肺切除术后的术后并发症发生率或生存率。

方法

对 2000 年至 2015 年间接受 NSCLC 切除术的 1219 名患者进行了回顾性分析。分析的合并症包括慢性阻塞性肺病（COPD）、高血压、冠状动脉疾病（CAD）、外周动脉疾病、心肌梗塞病史、糖尿病、肾功能不全和其他恶性肿瘤。

结果

大多数患者（78.9%）有合并症，最常见的是高血压（34.1%），其次是慢性阻塞性肺病（26.4%）和其他恶性肿瘤（19%）。总体并发症发生率为 38.6%（肺部 26.4%；心脏 14.8%；胃肠道 3.0%）。高血压（优势比 (OR) = 1.492 ，p  = 0.031）与更多的心脏并发症相关。大量吸烟（OR = 1.008，p  = 0.003）和低体重指数（BMI）（OR = 0.932 ，p  < 0.001）显着影响肺部并发症的发生率。纳入的合并症均未对总体并发症发生率或生存率产生负面影响。然而，高龄 ( p  < 0.001)、低 BMI ( p  = 0.008) 和低 FEV1 ( p = 0.008）影响总体并发症发生率和生存率（每个p  < 0.001）。

结论

高龄、低 BMI 和低 FEV1 预示着接受 NSCLC 切除术的患者并发症风险更大，长期生存期更短。心脏并发症与高血压和 CAD 相关，而肺部并发症与高包装年数相关。