Risk Factors For Non-Cancer Death After Surgery In Patients With Stage I Non-Small-Cell Lung Cancer

OBJECTIVES: With improvements in the outcome of treatment for non-small-cell lung cancer (NSCLC), other diseases may account for a high death rate after surgery in patients with stage I NSCLC. In the present study, we analysed the associations between the clinical factors and non-cancer death after surgery in these patients.METHODS: The records of 514 patients with stage I NSCLC who underwent surgery were retrospectively reviewed; a proportional hazards model for the subdistribution of a competing risk was conducted to define the risk factors for non-cancer death.RESULTS: The mean patient age was 67years. A total of 367 patients (71%) underwent bilobectomy or lobectomy while 147 (29%) underwent sublobar resection. The pathological stage was IA in 386 (75%) and IB in 128 (25%) patients. Three patients (0.6%) died within 90days after surgery, and 108 (21%) experienced postoperative complications. Until the time of writing this report, 83 patients had died during the follow-up. The cause of death was primary lung cancer in 38 (46%) patients and other diseases in 45 (54%) patients, including non-cancer causes in 29 patients, such as pneumonia, cardiac death and cerebral stroke. According to a multivariable competing risk analysis for non-cancer death age (>= 70years), sex (male), body mass index (BMI <18.5), postoperative complications and % forced expiratory volume in 1s (<80) were identified as risk factors for postoperative non-cancer death.CONCLUSIONS: Advanced age (>= 70years), male sex, low BMI (<18.5), postoperative complications and low preoperative % forced expiratory volume in 1s (<80) were found to be the risk factors for postoperative non-cancer death after surgery in patients with stage I NSCLC.