To propose a treatment strategy for simultaneously discovered non-small cell lung cancer (NSCLC) and cardiovascular disease (CVD).
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.
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 %.
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.
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Takahashi T, Nakano S, Shimazaki Y, Kaneko M, Nakahara K, Miyata M, et al. Concomitant coronary bypass grafting and curative surgery for cancer. Surg Today. 1995;25:131–5.
Takahashi T, Ohtake S, Ueno T, Koh M, Sawa Y, Matsuda H. Off-pump coronary bypass using interposed radial artery graft. Ann Thorac Surg. 1998;66:2096–8.
Nishi H, Sakaguchi T, Miyagawa S, Yoshikawa Y, Fukushima S, et al. Optimal coronary artery bypass grafting strategy for acute coronary syndrome. Gen Thorac Cardiovasc Surg. 2014;62:357–63.
Nishimura M, Ohtake S, Sawa Y, Imagawa H, Yamakawa T, Nakamura T, et al. Endovascular stent graft placement for patients with aortic aneurysm and end-organ dysfunction. ASAIO J. 1998;44:M511–5.
Kuratani T, Sawa Y. Current strategy of endovascular aortic repair for thoracic aortic aneurysms. Gen Thorac Cardiovasc Surg. 2010;58:393–8.
Hosoba S, Hanaoka J, Suzuki T, Takashima N, Kambara A, Matsubayashi K, et al. Early to midterm results of cardiac surgery with concomitant pulmonary resection. Ann Thorac Cardiovasc Surg. 2012;18:8–11.
Inoue M, Minami M, Sawabata N, Kadota Y, Shintani Y, Nakagiri T, et al. Surgical treatment strategy for small-sized, non-small cell lung cancer: a proposal algorithm for limited resection. J Jpn Assoc Chest Surg. 2010;24:1004–10.
Sawabata N, Kanzaki R, Sakamoto T, Kusumoto H, Kimura T, Nojiri T, et al. Clinical predictor of pre- or minimally invasive pulmonary adenocarcinoma: possibility of sub-classification of clinical T1a. Eur J Cardiothorac Surg. 2013;45:256–61.
Sawabata N. Prognosis of lung cancer patients in Japan according to data from the Japanese joint committee of lung cancer registry. Respir Investig. 2014;52:317–21.
Takamochi K, Oh S, Matsuoka J, Suzuki K. Risk factors for morbidity after pulmonary resection for lung cancer in younger and elderly patients. Interact Cardiovasc Thorac Surg. 2011;12:739–43.
Crawford ES, Morris GC Jr, Howell JF, Flynn WF, Moorhead DT. Operative risk in patients with previous coronary artery bypass. Ann Thorac Surg. 1978;26:215–21.
Yokoyama H. Preoperative evaluation and management of patients with ischemic heart disease undergoing noncardiac surgery. J Jpn Surg Soc. 2005;106:323–7.
Takase S, Yokoyama H. Cardiac and aortic surgery for patients with malignant tumors. Kyobu Geka. 2012;65:625–35.
Morishita K, Kawaharada N, Watanabe T, Koshima R, Fujisawa Y, Watanabe A, et al. Simultaneous cardiac operations with pulmonary resection for lung carcinoma. Jpn J Thorac Cardiovasc Surg. 2001;49:685–9.
Patane F, Verzini A, Zingarelli E, di Summa M. Simultaneous operation for cardiac disease and lung cancer. Interact Cardiovasc Thorac Surg. 2002;1:69–71.
Saxena P, Tam RK. Combined off-pump coronary artery bypass surgery and pulmonary resection. Ann Thorac Surg. 2004;78:498–501.
Schoenmakers MC, van Boven WJ, van den Bosch J, van Swieten HA. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg. 2007;84:504–9.
Dyszkiewicz W, Jemielity M, Piwkowski C, Kasprzyk M, Perek B, Gasiorowski L, et al. The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease. Eur J Cardiothorac Surg. 2008;34:531–5.
Cathenis K, Hamerlijnck R, Vermassen F, Van Nooten G, Muysoms F. Concomitant cardiac surgery and pulmonary resection. Acta Chir Belg. 2009;109:306–11.
Zhang R, Wiegmann B, Fischer S, Dickgreber NJ, Hagl C, Kruger M, et al. Simultaneous cardiac and lung surgery for incidental solitary pulmonary nodule: learning from the past. Thorac Cardiovasc Surg. 2012;60:150–5.
Larmann J, Theilmeier G. Inflammatory response to cardiac surgery: cardiopulmonary bypass versus non-cardiopulmonary bypass surgery. Best Pract Res Clin Anaesthesiol. 2004;18:425–38.
Conflict of interest
The authors declare no conflicts of interest in association with this study.
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Kanzaki, R., Kimura, T., Kawamura, T. et al. Treatment of simultaneously discovered lung cancer and cardiovascular disease: a 20-year single-institution experience. Surg Today 47, 726–732 (2017). https://doi.org/10.1007/s00595-016-1424-3
- Lung cancer
- Cardiovascular disease