The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome

Abstract Backgrounds Lung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment. Methods This retrospective study reviewed data from all lung cancer patien...

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Main Authors: Julia Zimmermann, Julia Walter, Mircea Gabriel Stoleriu, Julia Kovács, Gökce Yavuz, Fuad Damirov, Niels Reinmuth, Martina Merk, Rudolf A. Hatz, Amanda Tufman, Christian P. Schneider
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02995-6
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author Julia Zimmermann
Julia Walter
Mircea Gabriel Stoleriu
Julia Kovács
Gökce Yavuz
Fuad Damirov
Niels Reinmuth
Martina Merk
Rudolf A. Hatz
Amanda Tufman
Christian P. Schneider
author_facet Julia Zimmermann
Julia Walter
Mircea Gabriel Stoleriu
Julia Kovács
Gökce Yavuz
Fuad Damirov
Niels Reinmuth
Martina Merk
Rudolf A. Hatz
Amanda Tufman
Christian P. Schneider
author_sort Julia Zimmermann
collection DOAJ
description Abstract Backgrounds Lung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment. Methods This retrospective study reviewed data from all lung cancer patients who underwent lobectomy or segmentectomy at the Lung Cancer Center Munich between 2011 and 2020. We compared numerical outcomes between patients with minimally invasive surgery and patients with thoracotomy using t-test, and categorical outcomes using Chi2-test or fishers exact test when cell counts were < 6. We used multivariate Cox Regression to model the association between comorbidities and overall survival. Results 1658 patients (556 minimally invasive,1102 thoracotomy) were included. Across the entire population the comorbidity with the strongest association to death was chronic lymphatic leukemia (HR = 5.15, p = < 0.001), followed by pulmonary fibrosis (HR = 4.06, p = < 0.001), mild liver disease (HR = 2.18, p = 0.02), peripheral arterial disease (HR = 1.48, p = 0.04) and chronic obstructive pulmonary disease (HR = 1.42, p = < 0.01). In the minimally invasive surgery group chronic lymphatic leukemia was most strongly associated with death (HR = 14.31, p = 0.01). This was followed by mild liver disease (HR = 5.01, p = 0.01) and myocardial infarction (HR = 2.45, p = 0.04). Whereas in the thoracotomy group the strongest associations were fibrosis (HR = 4.20, p = < 0.001) and COPD (HR = 1.51,p = < 0.01). Conclusion Most of the comorbidities analyzed do not have a major impact on all-cause mortality after lung surgery. Those that do have a high impact tend to have a very low prevalence.
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spelling doaj-art-b311dbbce13547a780a4e367de992c6d2025-08-20T03:37:28ZengBMCBMC Surgery1471-24822025-07-0125111110.1186/s12893-025-02995-6The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidomeJulia Zimmermann0Julia Walter1Mircea Gabriel Stoleriu2Julia Kovács3Gökce Yavuz4Fuad Damirov5Niels Reinmuth6Martina Merk7Rudolf A. Hatz8Amanda Tufman9Christian P. Schneider10Division of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDepartment of Internal Medicine V, LMU University HospitalDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDepartment of Thoracic Oncology, Asklepios Lung Clinic GautingDepartment of Thoracic Oncology, Asklepios Lung Clinic GautingDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingDepartment of Internal Medicine V, LMU University HospitalDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic GautingAbstract Backgrounds Lung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment. Methods This retrospective study reviewed data from all lung cancer patients who underwent lobectomy or segmentectomy at the Lung Cancer Center Munich between 2011 and 2020. We compared numerical outcomes between patients with minimally invasive surgery and patients with thoracotomy using t-test, and categorical outcomes using Chi2-test or fishers exact test when cell counts were < 6. We used multivariate Cox Regression to model the association between comorbidities and overall survival. Results 1658 patients (556 minimally invasive,1102 thoracotomy) were included. Across the entire population the comorbidity with the strongest association to death was chronic lymphatic leukemia (HR = 5.15, p = < 0.001), followed by pulmonary fibrosis (HR = 4.06, p = < 0.001), mild liver disease (HR = 2.18, p = 0.02), peripheral arterial disease (HR = 1.48, p = 0.04) and chronic obstructive pulmonary disease (HR = 1.42, p = < 0.01). In the minimally invasive surgery group chronic lymphatic leukemia was most strongly associated with death (HR = 14.31, p = 0.01). This was followed by mild liver disease (HR = 5.01, p = 0.01) and myocardial infarction (HR = 2.45, p = 0.04). Whereas in the thoracotomy group the strongest associations were fibrosis (HR = 4.20, p = < 0.001) and COPD (HR = 1.51,p = < 0.01). Conclusion Most of the comorbidities analyzed do not have a major impact on all-cause mortality after lung surgery. Those that do have a high impact tend to have a very low prevalence.https://doi.org/10.1186/s12893-025-02995-6Non-small cell lung cancerSurgeryComorbiditiesComorbidomeThoracotomyVideo-assisted thoracoscopic surgery
spellingShingle Julia Zimmermann
Julia Walter
Mircea Gabriel Stoleriu
Julia Kovács
Gökce Yavuz
Fuad Damirov
Niels Reinmuth
Martina Merk
Rudolf A. Hatz
Amanda Tufman
Christian P. Schneider
The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
BMC Surgery
Non-small cell lung cancer
Surgery
Comorbidities
Comorbidome
Thoracotomy
Video-assisted thoracoscopic surgery
title The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
title_full The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
title_fullStr The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
title_full_unstemmed The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
title_short The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome
title_sort impact of comorbidities on the all cause mortality of surgically treated non small cell lung cancer patients visualization with the aid of a comorbidome
topic Non-small cell lung cancer
Surgery
Comorbidities
Comorbidome
Thoracotomy
Video-assisted thoracoscopic surgery
url https://doi.org/10.1186/s12893-025-02995-6
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