Key result
Concomitant lung resection and cardiac surgery yields ~6% hospital mortality and 42% 5-year survival.
Why the study?
The safety and long-term survival outcomes of pulmonary resection for lung cancer combined with concomitant cardiac operations using extracorporeal circulation were not well established.
Does concomitant open heart surgery and pulmonary resection result in acceptable mortality and long-term survival in patients with lung cancer and cardiac disease?
Cohort (n=79)
Does concomitant open heart surgery and pulmonary resection result in acceptable mortality and long-term survival in patients with lung cancer and cardiac disease?
Concomitant open heart surgery and pulmonary resection for lung cancer is feasible with acceptable operative mortality (6.3%) and a 5-year survival rate of 42%.
Combined procedures may be feasible in select patients; leaves open need for modern prospective data on outcomes and selection.
From 1979 to 1993, 79 patients underwent pulmonary resection for lung cancer and a concomitant cardiac operation using extracorporeal circulation. There were 75 men and 4 women with a mean age of 65 years (range 52-77). Cardiac procedures consisted of coronary artery bypass grafting (CABG) in 69 patients (three redos), aortic valve replacement in 7 (2 combined with CABG), mitral valve repair in 1 (combined with CABG) and other in 2. In CABG cases the mean number of distal anastomoses was 4.0. Pulmonary resection included bilateral lobectomy in 1 patient, sleeve lobectomy in 3, pneumonectomy in 6, bilobectomy in 5, lobectomy in 60 and segmental resection in 4. Postoperatively 52 patients were stage I (65.8%), 18 stage II (22.8%) and 9 stage III a. Histology was squamous cell carcinoma in 48 patients (61%) and adenocarcinoma in 24 patients (30%). The hospital mortality was 6.3% (n = 5). Re-exploration for bleeding was necessary in seven patients. Follow-up was complete for all patients. The estimated mean survival for all patients (including hospital deaths) was 58 months. Two- and five-year survival rates were 62% and 42% with 45 and 22 patients, respectively, under surveillance. Lung cancer accounted for 64% of the late deaths. We conclude that pulmonary resection for lung cancer in patients undergoing a concomitant cardiac operation can be performed safely with low operative morbidity and mortality and good long-term survival.
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BRUTELDELARIVIERE et al. (1995) conducted a cohort in Lung cancer requiring pulmonary resection and concomitant cardiac operation (n=79). Concomitant pulmonary resection and cardiac operation was evaluated on Hospital mortality. Concomitant pulmonary resection for lung cancer and cardiac surgery was performed with a hospital mortality of 6.3% and a 5-year survival rate of 42%.
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