Korean J Thorac Cardiovasc Surg.  2017 Apr;50(2):86-93. 10.5090/kjtcs.2017.50.2.86.

Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Dong-A University College of Medicine, Korea. sungsil1st@gmail.com

Abstract

BACKGROUND
The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC.
METHODS
Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease.
RESULTS
The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival.
CONCLUSION
This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

Keyword

Non-small-cell lung carcinoma; Lifestyle; Postoperative complications; Survival

MeSH Terms

Acute Kidney Injury
Aged*
Atrial Fibrillation
Body Mass Index
Carcinoma, Non-Small-Cell Lung*
Delirium
Hospital Mortality
Humans
Hypertension
Life Style*
Mortality
Multivariate Analysis
Myocardial Ischemia
Pneumonia
Postoperative Complications*
Pulmonary Atelectasis
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Risk Factors
Smoke
Smoking
Stroke
Survival Rate
Smoke
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