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Lung Cancer |

Impact of Smoking on Postoperative Complications of Surgical Resection for Lung Cancer

Ileana Palma*, MD; Silvia Quadrelli, MD; Gustavo Lyons, MD; Leonardo Pankl, MD; Tamara Decima, MD; Lorena Delisio, MD; Domingo Chimondeguy, MD
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British Hospital of Buenos Aires, Buenos Aires, Argentina


Chest. 2012;142(4_MeetingAbstracts):631A. doi:10.1378/chest.1389445
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Abstract

SESSION TYPE: Lung Cancer Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To analyze the influence of smoking on postoperative complications in patients with Non Small Cell Lung Cancer (NSCLC) undergoing a surgical procedure with curative intent.

METHODS: Retrospectively collected data were analysed, at a single center, on 593 patients undergoing lung resection for NSCLC between January 1986 and November 2011. Smokers were those who had smoked at least 100 cigarettes in their life.

RESULTS: 593 patients were included (60.9 ± 10 year-old), reliable information about smoking was available in 564, 86.5% were smokers. Smokers were, more often men (74.6 vs. 35.5%, p = 0.000), symptomatic (41.9 vs. 24.3%, p = 0.005) and had lower prevalence of previous malignancies (8.9 vs. 18.6%, p = 0.029) compared with non-smokers patients. The frequency of presentation as SPN, right side, or the central location were not different, but smokers had significantly higher frequency of clinical N2 (10.8 vs. 2.7%, p = 0.029), prevalence of tumors larger than 3 cm (61.7 vs 44.6%, p = 0.009), and prevalence of squamous cell carcinomas (20.9% vs 6.6%, p = 0.003). Resection was considered curative in a similar percentage (86.8 vs. 91.8%, p = 0.231). The rate of postoperative complications (23.5 vs 21.9%, p = 0.758) or operative mortality (5.5 vs 5.3%, p = 0.920) were not different. However, when the period of the last 10 years was analysed, we observed a lower complication rate (15.6 vs. 29.4%, p = 0.001) and operative mortality (3.3 vs 7.4%, p = 0.025) compared with patients undergoing lung resection before 2002. In the whole population (smokers and non-smokers) logistic regression identified age over 75 years (OR 0.41 [95% CI, 0.20 to 0.81], p = 0.011), and surgery performed before 2002 (OR 2.14 [95% CI, 1.35 to 3.37], p = 0.001) as factors independently associated with postoperative complications: Smoking was not an independent predictor (OR 1.09 [95% CI, 0.55 to 2.15], p = 0.800).

CONCLUSIONS: A history of smoking was not a risk factor for complications and operative mortality in our series.

CLINICAL IMPLICATIONS: We believe that improvement in perioperative management during the last decade has been responsible of counterbalancing the potential adverse impact of smoking.

DISCLOSURE: The following authors have nothing to disclose: Ileana Palma, Silvia Quadrelli, Gustavo Lyons, Leonardo Pankl, Tamara Decima, Lorena Delisio, Domingo Chimondeguy

No Product/Research Disclosure Information

British Hospital of Buenos Aires, Buenos Aires, Argentina

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