78P - Lung resection for cancer in patients with heart disease: Management and postoperative outcome

Date 05 April 2019
Event European Lung Cancer Congress 2019
Topics Cancer Treatment in Patients with Comorbidities
Presenter Fatmir Caushi
Citation Annals of Oncology (2019) 30 (suppl_2): ii26-ii30. 10.1093/annonc/mdz064
Authors F.S. Caushi1, I. Skenduli2, A. Hatibi1, A. Mezini1, S. Telo1, S. Bala1, E. Shima1, A. Cani1
  • 1University Hospital of Lung Disease "Shefqet Ndroqi", 1023 - Tirana/AL
  • 2University Hospital of Lung Disease "Shefqet Ndroqi", Tirana/AL

Abstract

Background

Patients with lung cancer sometimes presents with concomitant heart disease. That kind of patients represents a high risk group necessitating prompt diagnosis and treatment. As lung resection still is the treatment of choice for early stages of lung cancer, its feasibility depends on the severity of the cardiac impairment. The aim of this study was to analyze the results of lung resection in patients with heart disease in terms of 30 day postoperative mortality, hospital stay and 5 year survival.

Methods

This was a retrospective analysis of 161 patients with lung cancer who underwent complete lung resection between January 2011 and January 2014 at our department.

Results

Surgery consisted in 140 lobectomies, 21 pneumonectomies. 24,2% of patients (39) of this study had a cardiac disease as co-morbidity where 14 of them was suffering from hyper tension of second stage, 10 of them from chronic atrial fibrillation, 14 patients (8.7%) with coronary artery disease where 10 of them have been treated previously by CABG or PTCA revascularization procedure meanwhile in 4 patients the disease was diagnosed in routine examinations. One patient had undergone a cardiac surgery for mitral valve replacement. In both of 4 patients that were diagnosed with coronary disease was not required myocardial revascularization despite presented a medium-high cardiac risk and the surgery was performed under the continuous control of cardiologists. The mortality rate was 3%. There was one intraoperative death because of cardiac arrhythmia, and 4 deaths in first 30 days post operation (one of them because of heart attack in a pre-treated coronary disease by PTCA and 3 others by severe pneumonia). Hospital stay was longer for patients who had cardiac co-morbidity (12.3±4 vs. 8.5±3 days). The overall 5-year survival rate was 60%. In patients cardiopulmonary co-morbidity the 5-year survival rate was 40%.

Conclusions

Lung resection in patients with cardiac disease is feasible. Careful preoperative evaluation can identify patients who might benefit from myocardial revascularization prior to surgery. A careful cardiac treatment and follow-up of such patients its necessary to achieve better results regarding mortality and 5-year survival.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Fatmir Caushi.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.