Surgical outcomes, survival and prognostic factors in a cohort of lung cancer patients operated at the University of Chile Clinical Hospital.

Abstract

Introduction: Lung cancer is the leading cause of death by cancer worldwide and has a high lethality. The best treatment for patients with localized disease is anatomical surgical resection, granting good average survival in the long term. We did not find Chilean studies focusing on complications, long term survival or potential association with pathological or clinical factors. The aim of this work is to describe clinical characteristics, surgical complications and 5-to-10-year survival of a cohort of lung cancer patients operated in the Clinical Hospital of University of Chile and explore possible prognostic factors influencing in it.

Methods: A 107 patient's cohort of operated lung cancer patients in a single center from 2004 to 2015 was analyzed. We included patients with curative intent surgery performed in our hospital and excluded non- primary lung cancer histology or biopsies analyzed in other center. Clinical, perioperative and histopathologic data were collected. 5-10 year overall survival was determined and an exploratory analysis of prognostic factors on survival was performed.

Results: We found 107 surgeries fulfilling criteria, with 27% morbidity and 5.6% and 6.5% mortality at 30 and 90 days, respectively. 5- and 10-year overall survival was 44.7% and 32.3%, respectively. Univariate analysis found that gender, age, histology, disease stage, loco-regional dissemination and postoperative complications were factors associated with survival. Multivariate analysis confirmed that gender, age, loco-regional dissemination and postoperative complications were independent factors associated with survival.

Conclusions: Surgical results of a cohort of patients operated in a Chilean center show that 30 and 90-days mortality aligned with data reported worldwide. Overall survival in these selected patients is far better than reported in lung cancer patients. Risk factors that may be screened in preoperative analysis were found, which could change prognosis. Those findings suggest that improving preoperative evaluation could optimize patient selection to obtain better performance in surgical results and overall long-term survival.