Cuts like a knife.

Two recent studies look at what happens after lung cancer resections. The first is (another) NCDB analysis of postoperative mortality for early-stage lung cancer. Mortality rates at 30 and 90 days were about 2% and 4%, respectively, with age >70 and extent of resection significantly increasing those rates.  The second observational study from Spain looks at readmissions after lung cancer resection. The 30-day readmission rate was 6% and those who were readmitted subsequently had a significantly higher rate of 90-day mortality at 15% compared to 1.5%. Major reasons for readmission were air leak and infection, and patients with comorbidities were much more likely to be admitted. In comparison, and to no surprise, early mortality is much lower for lung SBRT, historically about 1% at 30 days. TBL: Careful patient selection is important for lung cancer surgery because post-op mortality can be substantial in older patients who often have several comorbidities--as well as a safer alternative.