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Lung cancer surgery effective even on high-risk patients

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Emory cardiothoracic surgeon Manu Sancheti wanted to test the notion that patients considered high-risk with early stage lung cancer should be treated only with nonsurgical therapies.

So he compared clinical outcomes of high-risk patients with those of standard-risk patients after lung cancer surgery.

The study, which ran in the Annals of Thoracic Surgery, concluded that surgical lung resection can be a safe and effective treatment even for high-risk patients with early stage lung cancer.

Previous research suggested that high-risk patients—60 and older, long-term smokers, with other health problems—were more likely to have complications or die after lung surgery. This led to one in five patients with stage I non-small-cell lung cancer being deemed inoperable or high-risk for surgery.

Using Emory data from the General Thoracic Surgery Database of the Society of Thoracic Surgeons, the team identified 310 standard-risk and 180 high-risk patients who underwent surgical resection for early stage lung cancer at Emory from 2009 to 2013.

While average length of hospital stay was one day longer for high-risk patients (five days) compared with standard-risk patients (four days), there was little difference between the two groups in post-operative mortality (2 percent for high-risk; 1 percent for standard-risk).

Researchers also found that the spread of cancer to the lymph nodes was discovered during surgery in about 20 percent of the high-risk patients—something that would not have been detected and treated with a non-surgical approach.

At three years post-surgery, 59 percent of high-risk and 76 percent of standard-risk patients were still alive.

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