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Original Articles: General Thoracic

Long-Term Outcome of Surgical Treatment for Non-Small Cell Lung Cancer With Comorbid Liver Cirrhosis

^a Department of Thoracic, Osaka City University Graduate School of Medicine, Osaka, Japan
^b Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

Accepted for publication July 9, 2007.

^_* Address correspondence to Dr Iwata, Department of Thoracic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan (Email: taiwata{at}med.osaka-cu.ac.jp).

Background: Long-term outcome of surgery for non-small cell lung cancer with comorbid liver cirrhosis is not well known. We aimed to establish the factors influencing survival in such cases.

Methods: We retrospectively reviewed 33 patients who had undergone surgery for non-small cell lung cancer with comorbid liver cirrhosis. Clinical features, early outcome, survival time, and cause of death were investigated. Factors influencing survival were estimated by univariate and multivariate analyses.

Results: There were 2 in-hospital deaths (6.5%). Five-year survival rate for lung cancer death (n = 9) was 59.7%, whereas for hepatic death (n = 6), it was 62.9%. Factors influencing lung cancer death were nodal stage and limited resection (p < 0.05 for each). Factors influencing hepatic death were serum total bilirubin (p < 0.0001) and cholinesterase (p < 0.05), platelet count (p < 0.05), and alpha-fetoprotein (p < 0.05). Lung disease factors such as local extensiveness of the tumor and pathologic stage, and surgical factors such as performance of mediastinal dissection and limited surgery, also influenced survival from hepatic death (p < 0.05 for each).

Conclusions: Although pulmonary resection invasiveness may have some impact on long-term liver function, the life expectancy of patients with cirrhosis does not seem to be severely affected by pulmonary resection itself. Curative surgery should be performed if possible, even in patients with cirrhosis.