Prospective assessment of 30-day operative morbidity for surgical resections in lung cancer

Prospective morbidity and mortality rates associated with resection of lung cancer that are reflective of the current trend toward preoperative therapy are not readily available in the current literature. To determine their prevalence, we prospectively analyzed the results of 783 resections performed within contributing Lung Cancer Study Group (LCSG) centers. There were 543 men and 240 women with a mean age of 63.44 years. Of the 783 resections, there were 411 lobectomies, 135 pneumonectomies, and 237 other procedures. Thirty patients died postoperatively (mortality, 3.8%) and 211 had a major complication (27%). Complications occurred more commonly in men (34.3%, p=0.001), in patients age 60 or older (34.0%, p=0.001), and in patients with a Karnofsky index <9 (44%, p<0.001). There was no significant difference between mortality, significant morbidity rates for lobectomy (28.2%), and pneumonectomy (31.9%), or for simple (28.3%) and extended resection (31.9%). The seemingly higher incidence of major postoperative events reported in this series not only reflects the prospective nature of this analysis but also the fact that over 25% of patients were in other therapeutic trials involving neoadjuvant or postoperative adjuvant regimens. Within that context, these data appear to be a reasonable estimate of modern surgical morbidity rates in the treatment of lung cancer.