Ann Thorac Surg 1996;62:346-347
© 1996 The Society of Thoracic Surgeons
Discussion
Discussion
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See also page 342.
DR PETER C. PAIROLERO (Rochester, MN): I thank Dr Rao for his excellent presentation. The issue of compromised survival for patients with lung cancer after concomitant pulmonary and cardiac operations is not new. Peters first suggested this association as early as 1982, when he suggested that alterations in the immune mechanism occurred after extracorporeal circulation that accelerated malignant disease. Since then, others, including our group, have suggested that it is less a matter of reduced immunocompetency and more a situation of incomplete cancer staging through a median sternotomy incision.
In our series of 30 patients with lung cancer presented before this Society 2 years ago, overall 5-year survival after concomitant pulmonary and cardiac operations was 35%. This is in marked contrast to the 64% five-year survival reported in the present study for patients with malignant disease. Equally as important, survival in our concomitant patients was not significantly affected by the stage of the disease, even though more than 75% of our patients were presumed to have stage I disease. Our observation of reduced survival was also in marked contrast to the survival observed in another of our patient groups, who had cardiac operations followed by staged pulmonary resections for lung cancer within the following year. Five-year survival for our staged patients was 53%. Why the differences? Well, for one thing, . . . [Full Text of this Article]
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Ann. Thorac. Surg. 1996 62: 342-346.
[Abstract]
[Full Text]
Copyright © 1996 by The Society of Thoracic Surgeons.
