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Published in: Surgery Today 7/2017

01-07-2017 | Original Article

Outcomes of surgery for lung cancer in patients with atrial fibrillation as a preoperative comorbidity: a decade of experience at a single institution in Japan

Authors: Ryu Kanzaki, Toru Kimura, Tomohiro Kawamura, Soichiro Funaki, Yasushi Shintani, Masato Minami, Meinoshin Okumura

Published in: Surgery Today | Issue 7/2017

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Abstract

Purpose

To investigate the surgical outcomes of surgery for non-small cell lung cancer (NSCLC) in patients with atrial fibrillation (AF) as a preoperative comorbidity.

Methods

Among 805 patients who underwent surgery for NSCLC, 27 (3.4%) had a history of AF. We analyzed the perioperative and long-term outcomes of these 27 patients.

Results

Fourteen patients (52%) had chronic AF and 13 (48%) had paroxysmal AF; being high rates of a comorbid illness. Nineteen patients (70%) underwent lobectomy, and 8 (30%) underwent sublobar resection. Ten patients (37%) received perioperative heparinization. There was no mortality. Other non-AF postoperative complications developed in 8 patients (30%), this incidence being higher than among the patients without AF (16%, 127 out of 778, p = 0.09). A thromboembolic event occurred in one patient (4%). With respect to the long-term outcomes, the 5-year overall survival and disease-free survival rates among the patients with AF were 70.3 and 60.8%, respectively, which were similar to those in the patients without AF (79.8 and 72.6%, p = 0.30 and 0.31).

Conclusions

Lung cancer surgery in patients with AF is safe and provides favorable long-term outcomes; however, thoracic surgeons should monitor these patients carefully for postoperative thromboembolic events.
Literature
1.
2.
go back to reference Sawabata N. Prognosis of lung cancer patients in Japan according to data from the Japanese Joint Committee of Lung Cancer Registry. Respir Investig. 2014;52:317–21.CrossRefPubMed Sawabata N. Prognosis of lung cancer patients in Japan according to data from the Japanese Joint Committee of Lung Cancer Registry. Respir Investig. 2014;52:317–21.CrossRefPubMed
3.
go back to reference Takamochi K, Oh S, Matsuoka J, Suzuki K. Risk factors for morbidity after pulmonary resection for lung cancer in younger and elderly patients. Interact CardioVasc Thorac Surg. 2011;12:739–43.CrossRefPubMed Takamochi K, Oh S, Matsuoka J, Suzuki K. Risk factors for morbidity after pulmonary resection for lung cancer in younger and elderly patients. Interact CardioVasc Thorac Surg. 2011;12:739–43.CrossRefPubMed
4.
go back to reference JCS Joint Working Group. Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2013). Circ J. 2014;78:1997–2021.CrossRef JCS Joint Working Group. Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2013). Circ J. 2014;78:1997–2021.CrossRef
5.
go back to reference Mokhles S, Verstegen N, Maat AP, Birim O, Bogers AJ, Mokhles MM, et al. Comparison of clinical outcome of st9.age I non-small cell lung cancer treated surgically or with stereotactic radiotherapy: results from propensity score analysis. Lung Cancer. 2015;87:283–9.CrossRefPubMed Mokhles S, Verstegen N, Maat AP, Birim O, Bogers AJ, Mokhles MM, et al. Comparison of clinical outcome of st9.age I non-small cell lung cancer treated surgically or with stereotactic radiotherapy: results from propensity score analysis. Lung Cancer. 2015;87:283–9.CrossRefPubMed
6.
go back to reference Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44.CrossRefPubMed Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44.CrossRefPubMed
7.
go back to reference Committee for the Third Edition of the COPD Guidelines of The Japanese Respiratory Society. Guidelines for the diagnosis and treatment of COPD (chronic obstructive disease), 3rd edn. Nihon Kokyuki Gakkai Zasshi 2009; Suppl Copd. Committee for the Third Edition of the COPD Guidelines of The Japanese Respiratory Society. Guidelines for the diagnosis and treatment of COPD (chronic obstructive disease), 3rd edn. Nihon Kokyuki Gakkai Zasshi 2009; Suppl Copd.
8.
go back to reference Japanese nephrology society. Clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012. Nihon Jinzo Gakkai Shi. 2012;54:1034–191. Japanese nephrology society. Clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012. Nihon Jinzo Gakkai Shi. 2012;54:1034–191.
9.
go back to reference Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864–70.CrossRefPubMed Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864–70.CrossRefPubMed
10.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
11.
go back to reference Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien–Dindo classifications of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien–Dindo classifications of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed
12.
go back to reference Vaughan Williams EM. Classification of antiarrhythmic drugs iSE, Flendsted-Jensen E, Olsen K teds: Symposium on Cardiac Arrhythmias. Sodertaije. Sweden AB Astra 1970; 449. Vaughan Williams EM. Classification of antiarrhythmic drugs iSE, Flendsted-Jensen E, Olsen K teds: Symposium on Cardiac Arrhythmias. Sodertaije. Sweden AB Astra 1970; 449.
13.
go back to reference Ohsawa M, Okayama A, Sakata K, Kato K, Itai K, Onoda T, et al. Rapid increase in estimated number of persons with atrial fibrillation in Japan: an analysis from national surveys on cardiovascular diseases in 1980, 1990 and 2000. J Epidemiol. 2005;15:194–6.CrossRefPubMed Ohsawa M, Okayama A, Sakata K, Kato K, Itai K, Onoda T, et al. Rapid increase in estimated number of persons with atrial fibrillation in Japan: an analysis from national surveys on cardiovascular diseases in 1980, 1990 and 2000. J Epidemiol. 2005;15:194–6.CrossRefPubMed
14.
go back to reference Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden DM, Aizawa Y. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009;58:629–36.CrossRef Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden DM, Aizawa Y. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009;58:629–36.CrossRef
15.
go back to reference Gu J, Liu X, Tan H, Zhou L, Jiang W, Wang Y, et al. Impact of chronic obstructive pulmonary disease on procedural outcomes and quality of life in patients with atrial fibrillation undergoing catheter ablation. J Cardiovasc Electrophysiol. 2013;24:148–54.CrossRefPubMed Gu J, Liu X, Tan H, Zhou L, Jiang W, Wang Y, et al. Impact of chronic obstructive pulmonary disease on procedural outcomes and quality of life in patients with atrial fibrillation undergoing catheter ablation. J Cardiovasc Electrophysiol. 2013;24:148–54.CrossRefPubMed
16.
go back to reference Moe GK, Abildskov JA. Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. Am Heart J. 1959;58:59–70.CrossRefPubMed Moe GK, Abildskov JA. Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. Am Heart J. 1959;58:59–70.CrossRefPubMed
17.
go back to reference Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, et al. Utility of B-natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings. Circulation. 2002;105:595–601.CrossRefPubMed Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, et al. Utility of B-natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings. Circulation. 2002;105:595–601.CrossRefPubMed
18.
go back to reference Lee SH, Jung JH, Choi SH, Lee N, Park WJ, Oh DJ, et al. Determinants of brain natriuretic peptide levels in patients with lone atrial fibrillation. Circ J. 2006;70:100–4.CrossRefPubMed Lee SH, Jung JH, Choi SH, Lee N, Park WJ, Oh DJ, et al. Determinants of brain natriuretic peptide levels in patients with lone atrial fibrillation. Circ J. 2006;70:100–4.CrossRefPubMed
19.
go back to reference Imperatori A, Mariscalco G, Riganti G, Rotolo N, Conti V, Dominioni L. Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study. J Cardiothorac Surg. 2012;7:4.CrossRefPubMedPubMedCentral Imperatori A, Mariscalco G, Riganti G, Rotolo N, Conti V, Dominioni L. Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study. J Cardiothorac Surg. 2012;7:4.CrossRefPubMedPubMedCentral
20.
go back to reference Hollings DD, Higgins RS, Faber LP, Warren WH, Liptay MJ, Basu S, et al. Age is a strong risk factor for atrial fibrillation after pulmonary lobectomy. Am J Surg. 2010;199:558–61.CrossRefPubMed Hollings DD, Higgins RS, Faber LP, Warren WH, Liptay MJ, Basu S, et al. Age is a strong risk factor for atrial fibrillation after pulmonary lobectomy. Am J Surg. 2010;199:558–61.CrossRefPubMed
21.
go back to reference Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44.CrossRefPubMed Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44.CrossRefPubMed
22.
go back to reference Inoue H, Nozawa T, Hirai T, Iwasa A, Okumura K, Lee JD, et al. Accumulation of risk factors increases risk of thromboembolic events in patients with nonvalvular atrial fibrillation. Circ J. 2006;70:651–6.CrossRefPubMed Inoue H, Nozawa T, Hirai T, Iwasa A, Okumura K, Lee JD, et al. Accumulation of risk factors increases risk of thromboembolic events in patients with nonvalvular atrial fibrillation. Circ J. 2006;70:651–6.CrossRefPubMed
23.
go back to reference Murasaki K. Guidelines for management of anticoagulant and antiplatelet therapy in cardiovascular disease (JCS 2009). Nihon Rinsho. 2011;69(Suppl 9):567–71.PubMed Murasaki K. Guidelines for management of anticoagulant and antiplatelet therapy in cardiovascular disease (JCS 2009). Nihon Rinsho. 2011;69(Suppl 9):567–71.PubMed
24.
go back to reference Sonobe M, Sato T, Chen F, Fujinaga T, Shoji T, Sakai H, et al. Management of patients with coronary stents in elective thoracic surgery. Gen Thorac Cardiovasc Surg. 2011;59:477–82.CrossRefPubMed Sonobe M, Sato T, Chen F, Fujinaga T, Shoji T, Sakai H, et al. Management of patients with coronary stents in elective thoracic surgery. Gen Thorac Cardiovasc Surg. 2011;59:477–82.CrossRefPubMed
25.
go back to reference Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, et al. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med. 2015;373:823–33.CrossRefPubMedPubMedCentral Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, et al. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med. 2015;373:823–33.CrossRefPubMedPubMedCentral
Metadata
Title
Outcomes of surgery for lung cancer in patients with atrial fibrillation as a preoperative comorbidity: a decade of experience at a single institution in Japan
Authors
Ryu Kanzaki
Toru Kimura
Tomohiro Kawamura
Soichiro Funaki
Yasushi Shintani
Masato Minami
Meinoshin Okumura
Publication date
01-07-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 7/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1436-z

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