Department of Cardiothoracic Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.
School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.
In Vivo. 2023 May-Jun;37(3):1358-1364. doi: 10.21873/invivo.13217.
BACKGROUND/AIM: Postoperative adverse events are associated with poor clinical outcomes and survival in patients with non-small-cell lung cancer (NSCLC) treated with curative operation. However, comprehensive evaluation of the clinical characteristics associated with postoperative adverse events and survival outcomes is lacking.
A retrospective study that evaluated patients with NSCLC who underwent curative surgery between 2008 and 2019 was conducted in a medical center. The baseline characteristics, five-item modified frailty index, sarcopenia, inflammatory biomarkers, surgical approach, postoperative adverse events, and survival were statistically analyzed.
Patients with a history of smoking and preoperative sarcopenia were at a higher risk of developing postoperative pulmonary complications. Smoking, frailty, and traditional open thoracotomy (OT) were associated with infections, and sarcopenia was identified as a risk factor for major complications. Advanced tumor stage, high neutrophil-to-lymphocyte ratio, OT, major complications, and infections were identified as risk factors for overall and disease-free survival.
Pre-treatment sarcopenia was found to be a predictor of major complications. Infections and major complications were associated with survival outcomes in patients with NSCLC.
背景/目的:术后不良事件与接受根治性手术治疗的非小细胞肺癌(NSCLC)患者的临床结局和生存不良相关。然而,缺乏对与术后不良事件和生存结局相关的临床特征的综合评估。
本研究回顾性分析了 2008 年至 2019 年在一家医疗中心接受根治性手术的 NSCLC 患者。对患者的基线特征、五项改良衰弱指数、肌肉减少症、炎症生物标志物、手术方式、术后不良事件和生存情况进行了统计学分析。
有吸烟史和术前肌肉减少症的患者发生术后肺部并发症的风险更高。吸烟、衰弱和传统开胸手术(OT)与感染相关,而肌肉减少症是发生主要并发症的危险因素。晚期肿瘤分期、高中性粒细胞与淋巴细胞比值、OT、主要并发症和感染是总生存和无病生存的危险因素。
术前肌肉减少症是主要并发症的预测指标。感染和主要并发症与 NSCLC 患者的生存结局相关。