Surgical intervention might be worth the risks, even for lung cancer patients considered to be high-risk by conventional guidelines from the American Association for Thoracic Surgery and other similar organizations. According to a new study, there is no difference in postoperative mortality between patients considered standard-risk and those considered high-risk—those aged 60 years and older, long-term smokers, and people with other health problems.
Surgery to remove infected parts of the lung can often be a safe and effective treatment option for patents with early-stage lung cancer. However, prior studies indicated that high-risk patients are more likely to die as a result of surgery. Nevertheless, new findings published in the Annals of Thoracic Surgery on Monday suggest otherwise.
Manu S. Sancheti, MD, lead author of the study and assistant professor of surgery at Emory University School of Medicine (Atlanta GA), analyzed with the help of his colleagues the outcomes of 490 early-stage lung cancer patients who underwent surgery at Emory University between 2009 and 2013. Of those patients who underwent surgery, 180 were considered to be high-risk.
Results of the study revealed only marginal differences between the standard- and high-risk groups. One of the few significant differences found was in the length of hospital stays after surgery: high-risk patients stayed an average of 5 days, whereas standard-risk patients only stayed 4 days on average. Postoperative death occurred in only 2% of high-risk patients, only 1% higher than the rate for those considered standard-risk.
Three-year survival rates were found to be significantly different between the two groups. Only 59% of high-risk patients survived 3 years versus 76% of standard-risk patients. Still, the authors of the study considered these rates acceptable compared with historical rates for nonsurgical therapies, especially when weighed against other benefits of surgery. For example, in 20% of cases, surgeons were able to find that cancer had spread to the patient’s lymph nodes and that adjunct chemotherapy was necessary, which would not have been discovered if surgery was not done.
Therefore, researchers concluded that high-risk patients should not necessarily be denied the opportunity to receive surgery and that better criteria is needed to identify the individuals most in danger of complications from surgery to treat lung cancer.
