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110. The Risk of Postoperative Complications After Major Elective Surgery in Active or Resolved COVID-19 in the United States.

Author

Deng, John Z., Chan, Janine S., Potter, Alexandra L., Chen, Ya-Wen, Sandhu, Harpal S., Panda, Nikhil, Chang, David C., and Yang, Chi-Fu Jeffrey

Abstract

Supplemental Digital Content is available in the text Objective: To assess the association between the timing of surgery relative to the development of Covid-19 and the risks of postoperative complications. Summary Background Data: It is unknown whether patients who recovered from Covid-19 and then underwent a major elective operation have an increased risk of developing postoperative complications. Methods: The risk of postoperative complications for patients with Covid-19 undergoing 18 major types of elective operations in the Covid-19 Research Database was evaluated using multivariable logistic regression. Patients were grouped by time of surgery relative to SARS-CoV-2 infection; that is, surgery performed: (1) before January 1, 2020 ("pre-Covid-19"), (2) 0 to 4 weeks after SARS-CoV-2 infection ("peri-Covid-19"), (3) 4 to 8 weeks after infection ("early post-Covid-19"), and (4) ≥8 weeks after infection ("late post-Covid-19"). Results: Of the 5479 patients who met study criteria, patients with peri-Covid-19 had an elevated risk of developing postoperative pneumonia [adjusted odds ratio (aOR), 6.46; 95% confidence interval (CI): 4.06–10.27], respiratory failure (aOR, 3.36; 95% CI: 2.22–5.10), pulmonary embolism (aOR, 2.73; 95% CI: 1.35–5.53), and sepsis (aOR, 3.67; 95% CI: 2.18–6.16) when compared to pre-Covid-19 patients. Early post-Covid-19 patients had an increased risk of developing postoperative pneumonia when compared to pre-Covid-19 patients (aOR, 2.44; 95% CI: 1.20–4.96). Late post-Covid-19 patients did not have an increased risk of postoperative complications when compared to pre-Covid-19 patients. Conclusions: Major, elective surgery 0 to 4 weeks after SARS-CoV-2 infection is associated with an increased risk of postoperative complications. Surgery performed 4 to 8 weeks after SARS-CoV-2 infection is still associated with an increased risk of postoperative pneumonia, whereas surgery 8 weeks after Covid-19 diagnosis is not associated with increased complications. [ABSTRACT FROM AUTHOR]

Published
2022
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112. The Optimal Treatment for Stage IIIA-N2 Non-Small Cell Lung Cancer:A Network Meta-Analysis

Author

Zhao, Yi, Wang, Wei, Liang, Hengrui, Yang, Chi-Fu Jeffrey, D'Amico, Thomas, Ng, Calvin S H, Liu, Chia-Chuan, Petersen, René Horsleben, Rocco, Gaetano, Brunelli, Alessandro, Liu, Jun, He, Jiaxi, Huang, Weizhe, Liang, Wenhua, He, Jianxing, Zhao, Yi, Wang, Wei, Liang, Hengrui, Yang, Chi-Fu Jeffrey, D'Amico, Thomas, Ng, Calvin S H, Liu, Chia-Chuan, Petersen, René Horsleben, Rocco, Gaetano, Brunelli, Alessandro, Liu, Jun, He, Jiaxi, Huang, Weizhe, Liang, Wenhua, and He, Jianxing

Abstract

BACKGROUND: The optimal treatment for stage IIIA-N2 non-small cell lung cancer (NSCLC) is controversial. We aimed to address this important issue through a Bayesian network meta-analysis.METHODS: We performed a search of electronic databases for randomized controlled trials comparing the following treatments: surgery, radiotherapy, chemotherapy, and their multiple combinations before March 25, 2018. Pooled data on overall survival and treatment-related deaths were analyzed within the Bayesian framework.RESULTS: Eighteen eligible trials reporting 13 treatments were included. In terms of overall survival, neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy or radiotherapy, which tended to be consistent (hazard ratio [HR] 1.14, 95% credible interval [CrI] 0.21 to 5.93), ranked superior to other treatments. Notably, neoadjuvant chemotherapy followed by surgery and adjuvant radiotherapy was significantly more effective in prolonging survival than surgery alone (HR 0.38, 95% CrI 0.18 to 0.81), surgery plus adjuvant radiotherapy (HR 0.51, 95% CrI 0.29 to 0.92) and potentially surgery plus adjuvant chemotherapy (HR 0.49, 95% CrI 0.23 to 1.05). Overall, with 29% as the highest possibility of causing the fewest treatment-related deaths, neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy or radiotherapy was the safest treatment option.CONCLUSIONS: Neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy or radiotherapy has the greatest possibility to be the optimal treatment with the best overall survival and fewest treatment-related deaths for stage IIIA-N2 NSCLC.

Published
2019

114. The Optimal Treatment for Stage IIIA-N2 Non-Small Cell Lung Cancer: A Network Meta-Analysis

Author

Zhao, Yi, primary, Wang, Wei, additional, Liang, Hengrui, additional, Yang, Chi-Fu Jeffrey, additional, D’Amico, Thomas, additional, Ng, Calvin S.H., additional, Liu, Chia-chuan, additional, Petersen, René Horsleben, additional, Rocco, Gaetano, additional, Brunelli, Alessandro, additional, Liu, Jun, additional, He, Jiaxi, additional, Huang, Weizhe, additional, Liang, Wenhua, additional, and He, Jianxing, additional

Published
2019
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118. A National Analysis of Short-term Outcomes and Long-term Survival Following Thoracoscopic Versus Open Lobectomy for Clinical Stage II Non-Small-Cell Lung Cancer.

Author

Yang, Chi-Fu Jeffrey, Kumar, Arvind, Deng, John Z., Raman, Vignesh, Lui, Natalie S., D'Amico, Thomas A., and Berry, Mark F.

Abstract

Supplemental Digital Content is available in the text Objective: To compare outcomes after open versus thoracoscopic (VATS) lobectomy for clinical stage II (cN1) non-small-cell lung cancer (NSCLC). Background: There have been no published studies evaluating the impact of a VATS approach to lobectomy for N1 NSCLC on short-term outcomes and survival. Methods: Outcomes of patients with clinical T1-2, N1, M0 NSCLC who underwent lobectomy without induction therapy in the National Cancer Data Base (2010–2012) were evaluated using multivariable Cox proportional hazards modeling and propensity score-matched analysis. Results: Median follow-up of 1559 lobectomies (1204 open and 355 VATS) was 43.2 months. The VATS approach was associated with a shorter median hospitalization (5 vs 6 d, P < 0.001) than the open approach. There were no significant differences between the VATS and open approach with regard to nodal upstaging (12.0% vs 10.5%, P = 0.41), 30-day mortality (2.3% vs 3.1%, P = 0.31), and overall survival (5-yr survival: 48.6% vs 48.7%, P = 0.76; multivariable-adjusted HR for VATS approach: 1.08, 95% CI: 0.90–1.30, P = 0.39). A propensity score-matched analysis of 334 open and 334 VATS patients who were well matched by 14 common prognostic covariates, including tumor size, and comorbidities, continued to show no significant differences in nodal upstaging, 30-day mortality, and 5-year survival between the VATS and open groups. Conclusion: In this national analysis, VATS lobectomy was used in the minority of N1 NSCLC cases but was associated with shorter hospitalization and similar nodal upstaging rates, 30-day mortality, and long-term survival when compared to open lobectomy. These findings suggest thoracoscopic techniques are feasible for the treatment of stage II (cN1) NSCLC. [ABSTRACT FROM AUTHOR]

Published
2021
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119. Response to

Author

Yang, Chi-Fu Jeffrey, primary, Kumar, Arvind, additional, Berry, Mark F., additional, and D’Amico, Thomas A., additional

Published
2018
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129. A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer

Author

Yerokun, Babatunde A., primary, Yang, Chi-Fu Jeffrey, additional, Gulack, Brian C., additional, Li, Xuechan, additional, Mulvihill, Michael S., additional, Gu, Lin, additional, Wang, Xiaofei, additional, Harpole, David H., additional, D'Amico, Thomas A., additional, Berry, Mark F., additional, and Hartwig, Matthew G., additional

Published
2017
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130. Surgery Versus Optimal Medical Management for N1 Small Cell Lung Cancer

Author

Yang, Chi-Fu Jeffrey, primary, Chan, Derek Y., additional, Speicher, Paul J., additional, Gulack, Brian C., additional, Tong, Betty C., additional, Hartwig, Matthew G., additional, Kelsey, Christopher R., additional, D’Amico, Thomas A., additional, Berry, Mark F., additional, and Harpole, David H., additional

Published
2017
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131. Reply to D.A. Palma

Author

Yang, Chi-Fu Jeffrey, primary, Chan, Derek Y., additional, D’Amico, Thomas A., additional, Berry, Mark F., additional, and Harpole, David H., additional

Published
2017
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132. Reply to T.-H. Wang et al

Author

Yang, Chi-Fu Jeffrey, primary, Chan, Derek Y., additional, Wang, Xiaofei, additional, D’Amico, Thomas A., additional, Harpole, David H., additional, and Berry, Mark F., additional

Published
2017
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143. Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base

Author

Yang, Chi-Fu Jeffrey, primary, Sun, Zhifei, additional, Speicher, Paul J., additional, Saud, Shakir M., additional, Gulack, Brian C., additional, Hartwig, Matthew G., additional, Harpole, David H., additional, Onaitis, Mark W., additional, Tong, Betty C., additional, D'Amico, Thomas A., additional, and Berry, Mark F., additional

Published
2016
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144. Impact of patient selection and treatment strategies on outcomes after lobectomy for biopsy-proven stage IIIA pN2 non-small cell lung cancer

Author

Yang, Chi-Fu Jeffrey, primary, Adil, Syed M., additional, Anderson, Kevin L., additional, Meyerhoff, Robert Ryan, additional, Turley, Ryan S., additional, Hartwig, Matthew G., additional, Harpole, David H., additional, Tong, Betty C., additional, Onaitis, Mark W., additional, D'Amico, Thomas A., additional, and Berry, Mark F., additional

Published
2015
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145. Long-term survival following open versus thoracoscopic lobectomy after preoperative chemotherapy for non-small cell lung cancer

Author

Yang, Chi-Fu Jeffrey, primary, Meyerhoff, Robert Ryan, additional, Mayne, Nicholas Ryan, additional, Singhapricha, Terry, additional, Toomey, Christopher B., additional, Speicher, Paul J., additional, Hartwig, Matthew G., additional, Tong, Betty C., additional, Onaitis, Mark W., additional, Harpole, David H., additional, D'Amico, Thomas A., additional, and Berry, Mark F., additional

Published
2015
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