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Vol.53 No.2 contents | Japanese/English |
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- Original Article -
Risk Assessment of Perioperative Mortality After Pulmonary Resection for Primary Lung Cancer: the 30-day or 90-day Mortality
Kenji Tomizawa1,5, Noriyasu Usami1, Koichi Fukumoto2, Noriaki Sakakura1, Takayuki Fukui2, Simon Ito3, Shunzo Hatooka4, Hiroyuki Kuwano5, Tetsuya Mitsudomi6, Yukinori Sakao11Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan, 2Division of Thoracic Surgery, Nagoya University Graduate School of Medicine, Japan, 3Department of Thoracic Surgery, Nagoya Daini Red Cross Hospital, Japan, 4Department of Thoracic Surgery, Ichinomiya Nishi Hospital, Japan, 5Department of General Surgical Science, Graduate School of Medicine, Gunma University, Japan, 6Division of Thoracic Surgery, Kinki University Hospital, Japan
Objective. Thirty-day mortality is adapted to the evaluation of perioperative mortality following pulmonary resection of primary lung cancer. However, whether 90-day mortality adequately evaluates perioperative mortality remains unknown. In this study, we analyzed the 30- and 90-day mortality following pulmonary resection of primary lung cancer at our institution. Methods. A total of 2207 pulmonary resections of primary lung cancer performed between 1996 and 2010 at Aichi Cancer Center Hospital were analyzed and divided into two groups of almost equal number: the early period (1070 patients treated between 1996 and 2004) and the late period (1137 patients treated between 2005 and 2010). Sixty-six and 34 postoperative deaths occurred within one year during the early and late periods, respectively. The causes of death (recurrence, bleeding, sudden death, respiratory failure and adverse events of chemotherapy) and 30- and 90-day mortality rates were investigated. Results. The 30- and 90-day mortality rates were 0.56% and 0.35%, respectively, during the early period and 0.75% and 0.79%, respectively, during the late period. Among the patients who died within one year after undergoing pulmonary resection, the postoperative survival of the patients with death due to recurrence (75 patients) and death due to bleeding or sudden death (seven patients) was > 91 days and < 30 days, respectively. The postoperative survival of the patients with death due to bleeding or sudden death (seven patients) was < 30 days. The median postoperative survival of the patients with respiratory failure was 67 days (range: 20-142 days) in the early period and 100 days (range: 47-149 days) in the late period. In the late period, adequately assessing perioperative mortality using 30-day mortality was difficult due to pulmonary complications. Conclusions. A risk assessment of perioperative mortality following pulmonary resection of primary lung cancer should be performed using 90- and 30-day mortality.
key words: 30-day mortality, 90-day mortality, Primary lung cancer
Received: December 21, 2012
Accepted: April 8, 2013
JJLC 53 (2): 93-98, 2013
