How Safe Is Surgery In Obese Lung Cancer Patients?

e17555 Background: Obesity is a risk factor for increased peri-operative morbidity and mortality in surgery. There have been limited studies to correlate morbidity of lung cancer resection with obesity. Methods: We performed a retrospective study of patients who underwent surgical resection for lung cancer at the Medical College of Wisconsin from 2006 to 2010. Data on patient demographics, weight, pathology findings and hospital course were abstracted after appropriate IRB approval. Peri-operative morbidity was defined as atrial fibrillation, heart failure, respiratory failure, pulmonary embolism or any medical complications arising within 30 days after surgery. Fisher’s exact test was used to test the association between BMI and perioperative morbidities. Results: Between 2006 and 2010, 320 lung resections were performed for lung cancer. Median age was 67 (25-88) years and 185 (57.8%) were females. The body mass index (BMI) distribution was 121 (37.8%) in BMI<25 and 199(62.18%) in BMI≥25. In patients with BMI < 25, surgical procedures consisted 76 (23.75%) lobectomy, 38 (11.8%) wedge resection and 7 (2.18%) pneumonectomy. In patients with BMI ≥ 25, surgical procedures consisted: 131 (40.93%) lobectomy, 61 (19.06%) wedge resection and 7 (2.18%) pneumonectomy. Tumor histology was: adenocarcinoma 138 (42.9%), squamous cell cancer 107 (33.3%), bronchoalveolar 25 (7.7%), large cell 19 (5.9%) and mixed 31 (9.68%). The 30-day mortality rate was 1.8 % (6 patients), out of which only 2 had BMI ≥ 25. Peri-operative morbidity occurred in 28 (23.14%) of normal BMI patients and 47 (23.6%) of BMI ≥ 25 patients (p=0.54). Specific morbidities encountered by patients with normal vs. BMI ≥ 25 were: atrial fibrillation 11(9.09%) vs. 24(12.06%) (p=0.46), pulmonary embolism 1(0.83%) vs. 3(1.51%) (p=1.0), congestive heart failure 2(1.65%) vs. 2(1.01%) (p=0.63), respiratory failure 12(9.92%) vs. 17(8.54%) (p=0.69) and ARDS 2(1.65%) vs. 1(0.50%) (p=0.55).Median hospital stay was 5 days in lower BMI group and 4 days in BMI ≥25 groups (p=0.52). Conclusions: Potential curative surgical resections can be offered to even significantly overweight patients as there is no significant difference in the peri-operative morbidities and length of stay as compared to normal BMI patients.