Postoperative Adverse Events are Associated with Oncologic Recurrence Following Curative-intent Resection for Lung...

Area of Science:

• Oncology
• Surgical Outcomes
• Infectious Disease

Background:

• Lung cancer resection can lead to short-term adverse events (AEs) and long-term metastatic recurrence.
• The link between postoperative AEs, particularly infections, and disease recurrence remains debated.
• This study investigates the association between AEs and recurrence risk after curative-intent lung cancer surgery.

Purpose of the Study:

• To evaluate the impact of postoperative adverse events (AEs) on the risk of recurrence.
• To assess the relationship between AEs and recurrence-free survival (RFS) following lung cancer resection.
• To clarify the controversial association between infectious AEs and disease recurrence.

Main Methods:

• Retrospective analysis of 892 patients undergoing curative-intent lung cancer resection (January 2008-July 2015).
• Prospective collection of AEs using the Thoracic Morbidity & Mortality System.
• Cox proportional hazards models and Kaplan-Meier curves analyzed AE impact on recurrence and RFS.

Main Results:

• 38.3% of patients experienced an AE; 7.7% had infectious AEs.
• Severe (Grade IV) AEs significantly increased recurrence risk (HR 3.40) and trended towards decreased RFS.
• Major infectious AEs were linked to higher recurrence risk (HR 1.71) and earlier recurrence (p=0.02).

Conclusions:

• Postoperative adverse events, particularly those involving critical illness or major infection, are associated with an increased risk of oncologic recurrence in lung cancer patients.
• These findings highlight the importance of managing AEs to potentially improve long-term cancer outcomes.
• The study suggests a significant link between postoperative complications and cancer recurrence following lung cancer resection.