Risk factors for malignancy-unrelated long-term respiratory events after pneumonectomy

Abstract

Background: In this study, we aimed to evaluate late-onset, malignancyunrelated respiratory events following pneumonectomy. Methods: The medical data of 78 patients (73 males, 5 females; mean age 55.6±9.6 years; range, 32 to 79 years) who underwent pneumonectomy in our clinic between January 2009 and September 2014 were retrospectively analyzed. Preoperatively, data including smoking habits, comorbidities, the American Society of Anesthesiologists risk score, the EuroSCORE, neoadjuvant chemotherapy need, cancer cell type, and clinical stage were recorded. Postoperatively, data included complications and treatment modalities were recorded. Results: The mean follow-up was 35.2±22.0 months (range 9 to 104 months). Malignancy-related respiratory events such as local relapse and a second primary lung tumor developed in 21 patients (35.0%). Non-malignancy-related respiratory events were seen in 18 patients (31.6%). Long-term, non-malignancy-related morbidity was more prevalent in the patients with high American Society of Anesthesiologists scores (p=0.01), preoperative forced expiratory volume in one second < 60% (p=0.05), and a high EuroSCORE (p=0.04). In multivariate analysis, non-malignancy-related respiratory events were found to be statistically significantly more frequent in the patients with high American Society of Anesthesiologists scores (p=0.01) and preoperative forced expiratory volume in one second < 60% (p=0.03). Conclusion: Our study results suggest that patients undergoing pneumonectomy may develop both short-term and long-term respiratory morbidities, and patients with high preoperative American Society of Anesthesiologists scores and low forced expiratory volume in one second are at an increased risk for non-malignancy-related morbidity. © 2017. Turkish Society of Cardiovascular Surgery.