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Risk Factors for Postoperative Complications after Pneumonectomy in Non-Small Cell Lung Cancer Patients
Meral Selin Onay Mahmuti1, Melike Ulker1, Ayşegul Ciftci1
1Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye.
Sisli Etfal Hastanesi Tip Bulteni
|July 10, 2026
Summary
Right-sided pneumonectomy, longer operative times, and blood loss increase complications in non-small cell lung cancer (NSCLC) patients. The age-adjusted Charlson Comorbidity Index (a-CCI) predicts survival but not complications.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Postoperative complications following pneumonectomy for non-small cell lung cancer (NSCLC) pose significant risks.
- Identifying preoperative factors influencing these complications is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of preoperative comorbidities, assessed by the age-adjusted Charlson Comorbidity Index (a-CCI), on postoperative complications in NSCLC patients undergoing pneumonectomy.
- To investigate the association between the a-CCI and survival outcomes in this patient cohort.
Main Methods:
- Retrospective analysis of 236 patients who underwent pneumonectomy for NSCLC between February 2018 and February 2023.
- Evaluation of demographic data, comorbidities (a-CCI), surgical details, postoperative complications (Clavien-Dindo), and survival outcomes.
Main Results:
- Postoperative complications occurred in 44.1% of patients.
- Complications were significantly associated with right-sided pneumonectomy, prolonged operative time, and increased intraoperative blood loss.
- The a-CCI did not predict postoperative complications but was significantly associated with reduced survival times (p=0.001).
Conclusions:
- Right-sided pneumonectomy, extended operative duration, and substantial blood loss are risk factors for postoperative complications in NSCLC patients.
- The a-CCI is a valuable prognostic indicator for survival but has limitations in predicting postoperative complications.
- Risk stratification and optimized perioperative strategies are essential for surgical candidates.
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