Treatment of simultaneously discovered lung cancer and cardiovascular disease: a 20-year single-institution experience.

Abstract

PURPOSE:

To propose a treatment strategy for simultaneously discovered non-small cell lung cancer (NSCLC) and cardiovascular disease (CVD).

METHODS:

Of 1302 patients who underwent surgery for NSCLC, CVD requiring invasive treatment was simultaneously discovered in 33 (3 %). The details of the treatments as well as the short- and long-term outcomes of pulmonary resection were analyzed.

RESULTS:

CVD included coronary artery disease in 20 patients, valvular disease in 6, abdominal aortic aneurysm in 5, and congenital heart disease in 2. Twenty-six patients underwent two-stage treatment, while seven received simultaneous surgery. In 23 patients whose treatment for CVD preceded that for lung cancer, the median interval between those treatments was 78 days (range 18-197 days). Postoperative complications occurred in 8 (31 %) of 26 patients who underwent 2-stage treatment and in 3 (43 %) of 7 who underwent simultaneous surgery. Notably, of 3 patients who underwent lobectomy or bilobectomy, 2 (67 %) experienced respiratory dysfunction that required intubation. The 5-year overall survival rate of all 33 patients was 84.5 %.

CONCLUSION:

The outcomes of two-stage treatment in the present cohort were favorable. Given our experience, simultaneous surgery for lung cancer and CVD should, therefore, be selected only for patients who may benefit from that strategy.

• Authors: Ryu Kanzaki, Toru Kimura, Tomohiro Kawamura, Soichiro Funaki, Yasushi Shintani, Masato Minami, Shigeru Miyagawa, Koichi Toda, Yoshiki Sawa, Meinoshin Okumura
• Journal: Surgery today (Surg Today) Vol. 47 Issue 6 Pg. 726-732 (Jun 2017) ISSN: 1436-2813 [Electronic] Japan
• PMID: 27688032 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung (complications, mortality, surgery)
• Cardiovascular Diseases (complications, mortality, surgery)
• Cardiovascular Surgical Procedures (mortality)
• Cohort Studies
• Female
• Humans
• Lung Neoplasms (complications, mortality, surgery)
• Male
• Middle Aged
• Pneumonectomy (mortality)
• Postoperative Complications (epidemiology)
• Survival Rate
• Time Factors
• Treatment Outcome