Respiratory Complications during Mid- and Long-Term Follow-Up Periods in Patients Who Underwent Pneumonectomy for Non-Small Cell Lung Cancer

Abstract

Background: Pneumonectomy is associated with higher early mortality and morbidity, and it is also known to predispose the patient to respiratory complications during mid- and long-term follow-up. Therefore, the purpose of this study was to identify risk factors associated with respiratory complications during the follow-up period after pneumonectomy.Methods: We retrospectively reviewed 98 patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC) between Jan 1995 and Dec 2005 Univariate and multivariate analyses were used to identify risk factors of late respiratory complications among preoperative and intraoperative data.Results: The median follow up duration of 98 patients was 33.1 months(4.2-180.0 months). The late mortality rate was 68.4% (n = 67). Causes of late death were cancer specific in 37 patients (55.2%) and respiratory specific in 25 patients(37.3%). Compared with 59 patients who had no respiratory infection after pneumonectomy during mid- or long-term follow-up, being male, a lower BMI (<22 kg/m²), presence of chronic obstructive pulmonary disease (COPD) and preoperative pneumonia were significant risk factors by univariate analysis. Multivariate analysis revealed that presence of preoperative pneumonia was the only independent factor associated with late mortality from respiratory complications during the mid- and long-term follow-up periods (OR = 2.41, 95% CI = 1.10−5.32, p = 0.028).Conclusion: Respiratory infection was a comparable risk factor of mortality in the mid- and long-term after pneumonectomy with cancer recurrence. The presence of preoperative pneumonia was an independent factor related to respiratory infection.Careful follow-up for these patients may be required.