Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer.

The role of chronic cardiopulmonary disease as a risk factor for immediate and late mortality was evaluated retrospectively in a consecutive series of 116 patients who had had resections for stage Ia non-oat-cell lung cancers. The presence of chronic cardiopulmonary disease was diagnosed on the clinical history and preoperative assessment of lung and heart function by traditional means. Patients with chronic cardiopulmonary disease showed a lower five-year survival rate than controls--35% versus 53% (p less than 0.08). The difference increased and became significant if besides having cardiopulmonary disease the patient was over 60 years of age or had had a pneumonectomy--30% versus 52% (p less than 0.025). A higher operative mortality was the main reason for the lower observed survival. Nevertheless, survival of patients at risk exceeded 30% in each subgroup, being 33% for patients over 60 undergoing pneumonectomy. In our series the benefits of resection of lung cancer in patients with impaired cardiopulmonary function were greater than the risks of perioperative and later death even in the groups with a poorer prognosis.