Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study

Background: Coronavirus disease (COVID)-19 can lead to chronic lung damage and respiratory issues, potentially increasing surgical difficulty and risk for patients with non-small-cell lung cancer (NSCLC). However, the impacts of a COVID-19 history on early outcomes in NSCLC patients remain controver...

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Main Authors: Hanbo Pan, Hang Chen, Wanyu Li, Yu Tian, Zhen Ge, Weicheng Kong, Zenan Gu, Ningyuan Zou, Hongda Zhu, Jiaqi Zhang, Yixing Tao, Junwei Ning, Jia Huang, Hui Yin, Ming Zhang, Chengwei Zhou, Hui Wang, Guodong Xu, Qingquan Luo
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Therapeutic Advances in Respiratory Disease
Online Access:https://doi.org/10.1177/17534666241298794
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author Hanbo Pan
Hang Chen
Wanyu Li
Yu Tian
Zhen Ge
Weicheng Kong
Zenan Gu
Ningyuan Zou
Hongda Zhu
Jiaqi Zhang
Yixing Tao
Junwei Ning
Jia Huang
Hui Yin
Ming Zhang
Chengwei Zhou
Hui Wang
Guodong Xu
Qingquan Luo
author_facet Hanbo Pan
Hang Chen
Wanyu Li
Yu Tian
Zhen Ge
Weicheng Kong
Zenan Gu
Ningyuan Zou
Hongda Zhu
Jiaqi Zhang
Yixing Tao
Junwei Ning
Jia Huang
Hui Yin
Ming Zhang
Chengwei Zhou
Hui Wang
Guodong Xu
Qingquan Luo
author_sort Hanbo Pan
collection DOAJ
description Background: Coronavirus disease (COVID)-19 can lead to chronic lung damage and respiratory issues, potentially increasing surgical difficulty and risk for patients with non-small-cell lung cancer (NSCLC). However, the impacts of a COVID-19 history on early outcomes in NSCLC patients remain controversial. Objectives: To evaluate the effect of COVID-19 history on early outcomes in NSCLC patients and identify high-risk groups undergoing radical resection based on the largest Chinese multi-center real-world data to date. Design: Multi-center retrospective cohort study. Methods: NSCLC patients with (POCVD group) or without (NCVD group) a history of COVID-19 who underwent radical surgery at six institutions from January 2022 to January 2024 were retrospectively reviewed from a prospectively maintained database. Propensity-score matching (PSM) was utilized to minimize patient selection bias. Results: Out of 7932 cases included, PSM resulted in 3021 cases per group. The two groups were comparable regarding the proportion of male patients (52.0% vs 51.6%) and those aged ⩾70 years (13.3% vs 13.8%). Although the two groups had comparable incidences of complications with Clavien-Dindo grades ⩾II (13.0% vs 14.4%, p  = 0.117), the POCVD group had longer surgical durations (120.87 ± 40.23 min vs 110.74 ± 38.76 min, mean difference (95% confidence interval (CI) = 10.13 (8.138–12.122)) and higher rates of respiratory complications than the NCVD group. Subgroup logistic regression analysis indicated that patients aged ⩾70 years (odds ratio (OR) (95% CI) = 1.322 (1.022–1.876)) and those with a smoking history (OR (95% CI) = 1.235 (1.008–1.543)) had an increased risk of developing complications with Clavien-Dindo grades ⩾II. Further analysis confirmed that these high-risk patients experienced extended surgical durations, longer chest tube drainage, and prolonged postoperative hospital stay, along with increased postoperative respiratory complications following COVID-19. Conclusion: Generally, radical resection is safe for NSCLC patients with a COVID-19 history. However, these patients experienced prolonged surgical durations and a higher incidence of postoperative respiratory complications compared to those without a COVID-19 history. In addition, individuals aged ⩾70 years or with a smoking history faced elevated surgical risks following COVID-19.
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series Therapeutic Advances in Respiratory Disease
spelling doaj-art-460695500cd24e7baddf2e5617f4d53a2024-11-20T05:03:34ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662024-11-011810.1177/17534666241298794Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world studyHanbo PanHang ChenWanyu LiYu TianZhen GeWeicheng KongZenan GuNingyuan ZouHongda ZhuJiaqi ZhangYixing TaoJunwei NingJia HuangHui YinMing ZhangChengwei ZhouHui WangGuodong XuQingquan LuoBackground: Coronavirus disease (COVID)-19 can lead to chronic lung damage and respiratory issues, potentially increasing surgical difficulty and risk for patients with non-small-cell lung cancer (NSCLC). However, the impacts of a COVID-19 history on early outcomes in NSCLC patients remain controversial. Objectives: To evaluate the effect of COVID-19 history on early outcomes in NSCLC patients and identify high-risk groups undergoing radical resection based on the largest Chinese multi-center real-world data to date. Design: Multi-center retrospective cohort study. Methods: NSCLC patients with (POCVD group) or without (NCVD group) a history of COVID-19 who underwent radical surgery at six institutions from January 2022 to January 2024 were retrospectively reviewed from a prospectively maintained database. Propensity-score matching (PSM) was utilized to minimize patient selection bias. Results: Out of 7932 cases included, PSM resulted in 3021 cases per group. The two groups were comparable regarding the proportion of male patients (52.0% vs 51.6%) and those aged ⩾70 years (13.3% vs 13.8%). Although the two groups had comparable incidences of complications with Clavien-Dindo grades ⩾II (13.0% vs 14.4%, p  = 0.117), the POCVD group had longer surgical durations (120.87 ± 40.23 min vs 110.74 ± 38.76 min, mean difference (95% confidence interval (CI) = 10.13 (8.138–12.122)) and higher rates of respiratory complications than the NCVD group. Subgroup logistic regression analysis indicated that patients aged ⩾70 years (odds ratio (OR) (95% CI) = 1.322 (1.022–1.876)) and those with a smoking history (OR (95% CI) = 1.235 (1.008–1.543)) had an increased risk of developing complications with Clavien-Dindo grades ⩾II. Further analysis confirmed that these high-risk patients experienced extended surgical durations, longer chest tube drainage, and prolonged postoperative hospital stay, along with increased postoperative respiratory complications following COVID-19. Conclusion: Generally, radical resection is safe for NSCLC patients with a COVID-19 history. However, these patients experienced prolonged surgical durations and a higher incidence of postoperative respiratory complications compared to those without a COVID-19 history. In addition, individuals aged ⩾70 years or with a smoking history faced elevated surgical risks following COVID-19.https://doi.org/10.1177/17534666241298794
spellingShingle Hanbo Pan
Hang Chen
Wanyu Li
Yu Tian
Zhen Ge
Weicheng Kong
Zenan Gu
Ningyuan Zou
Hongda Zhu
Jiaqi Zhang
Yixing Tao
Junwei Ning
Jia Huang
Hui Yin
Ming Zhang
Chengwei Zhou
Hui Wang
Guodong Xu
Qingquan Luo
Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
Therapeutic Advances in Respiratory Disease
title Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
title_full Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
title_fullStr Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
title_full_unstemmed Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
title_short Early outcomes of radical surgery in non-small-cell lung cancer patients with and without COVID-19 history: a multi-center real-world study
title_sort early outcomes of radical surgery in non small cell lung cancer patients with and without covid 19 history a multi center real world study
url https://doi.org/10.1177/17534666241298794
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