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

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Abstract
The role of chronic cadiopulmonary 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 5-yr survival rate than controls, 35 vs. 53% (P < 0.08). The difference increased and became significant if, besides having cardiopulmonary disease, the patient was > 60 yr of age or had had a pneumonectomy, 30 vs. 52% (P < 0.25). A higher operative mortality was the main reason for the lower observed survival. Survival of patients at risk exceeded 30% in each subgroup, being 33% for patients > 60 yr undergoing pneumonectomy. 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.