WCLC 2025 - Posters & ePosters-EP.07.22 Major Lung Resections for Non-Small Cell Lung Cancer: Does Postoperative Pneumonia Remain a Life-Threatening Complication?

EP.07.22 Major Lung Resections for Non-Small Cell Lung Cancer: Does Postoperative Pneumonia Remain a Life-Threatening Complication?

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This study from the University Medical Center Essen investigated the incidence, mortality, and risk factors of postoperative pneumonia in patients undergoing major lung resections for Non-Small Cell Lung Cancer (NSCLC) between 2016 and 2023. The analysis included 1,802 adult patients who received lobectomy, bilobectomy, or pneumonectomy, excluding those with wedge resections, other tumor types, or non-cancer diagnoses.<br /><br />Findings showed that postoperative pneumonia occurred in 4.5% of cases, predominantly following lobectomy (89.2%) compared to bilobectomy (4.0%) and pneumonectomy (6.8%). Surgical approaches included video-assisted thoracoscopic surgery (VATS) in 42% and thoracotomy in 58%. The overall 30-day mortality was 2.2%.<br /><br />Key independent risk factors for developing postoperative pneumonia included postoperative delirium (HR 13.66), renal failure (HR 7.31), and poor preoperative general condition, specifically an Eastern Cooperative Oncology Group (ECOG) performance status of 3 (HR 2.11). Other significant associations were found with older age (>70 years), low diffusing capacity of the lung for carbon monoxide (DLCO <60%), unexpected ICU admissions, and surgical revisions for bleeding.<br /><br />The study concludes that pneumonia remains a serious and potentially life-threatening complication after major lung resection for NSCLC. It highlights the importance of identifying high-risk patients early, particularly those with delirium, renal failure, or diminished functional status, to improve preventive strategies and outcomes. The authors suggest their findings could prompt multicenter studies to refine risk stratification and enhance postoperative care to reduce pneumonia incidence and associated mortality in this patient population.

Asset Subtitle

Konstantinos Grapatsas

Meta Tag

Speaker Konstantinos Grapatsas

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

Postoperative pneumonia

Non-Small Cell Lung Cancer

Lung resection

Lobectomy

Bilobectomy

Pneumonectomy

Risk factors

Mortality

Delirium

Renal failure