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Impact of postoperative complications on outcomes of second surgery for second primary lung cancer

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Abstract

Purpose

The best surgical approach for second primary lung cancer remains a subject of debate. The purpose of this study was to review the postoperative complications after second surgery for second primary lung cancer and to investigate the outcomes based on these complications.

Methods

The clinical data of 105 consecutive patients who underwent pulmonary resection for multiple primary lung cancers between January, 1996 and December, 2017, were reviewed according to the Martini–Melamed criteria.

Results

After the second surgery, low body mass index (BMI) (< 18.5 kg/m2) (P = 0.004) and high Charlson comorbidity index (CCI) (P = 0.002) were independent predictors of postoperative complications. Survival analysis revealed the 5-year overall survival rates of 74.5% and 61.4% for patients without postoperative complications and those with postoperative complications (P = 0.044), respectively, but the 5-year cancer-specific survival rates of 82.5% and 80.0% (P = 0.926), respectively. During this period, there were significantly more respiratory-related deaths of patients with complications than of those without complications (P = 0.011).

Conclusion

Surgical intervention is feasible and potentially effective for second primary lung cancer but may not achieve positive perioperative and long-term outcomes for patients with a low BMI or a high CCI. Treatment options should be considered carefully for these patients.

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Authors and Affiliations

  1. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Seijiro Sato, Masaya Nakamura, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike & Masanori Tsuchida

  2. Division of General Thoracic Surgery, Niigata Prefectural Central Hospital, Niigata, Japan

    Masaya Nakamura

  3. Division of General Thoracic Surgery, Niigata Prefectural Shibata Hospital, Niigata, Japan

    Akihiko Kitahara

Authors
  1. Seijiro Sato
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  2. Masaya Nakamura
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  3. Yuki Shimizu
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  4. Tatsuya Goto
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  5. Akihiko Kitahara
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  6. Terumoto Koike
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  7. Masanori Tsuchida
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Correspondence to Seijiro Sato.

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The authors have no conflicts of interest to declare in association with the present study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Sato, S., Nakamura, M., Shimizu, Y. et al. Impact of postoperative complications on outcomes of second surgery for second primary lung cancer. Surg Today 50, 1452–1460 (2020). https://doi.org/10.1007/s00595-020-02038-y

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  • DOI: https://doi.org/10.1007/s00595-020-02038-y

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