Three-dimensional computed tomography angiography for the preoperative evaluation of coronary artery disease in lung can
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Three-dimensional computed tomography angiography for the preoperative evaluation of coronary artery disease in lung cancer patients Fumiaki Watanabe1, Osamu Hataji1, Kentaro Ito1, Corina N D’Alessandro-Gabazza3, Masahiro Naito1, Hideo Morooka3, Esteban C Gabazza4*, Yukio Mizutani2, Maki Ohi2, Motoshi Takao5, Hideto Shimpo5 and Isao Yada1
Abstract Background: The number of elderly patients undergoing surgery for lung cancer is increasing. In this study, we assessed the usefulness of three-dimensional computed tomographicangiography (3D-CTA) for the detection of coronary disease in the elderly before surgical intervention for lung cancer. Methods: One hundred twenty patients admitted to our institution for lung cancer resection were enrolled in the study. 3D-CTA was performed in all 120 patients. Results: Seventy-one patients had normal findings, and forty-nine patients showed coronary stenosis on 3D-CTA examination. Among the latter 49 patients, 24 with slight stenosis underwent lung tumor resection, 23 had coronary angiography for severe stenosis before lung surgery and 2 were not eligible for lung resection because of very severe coronary stenosis. The diagnostic value of 3D-CTA was better than conventional CT. Conclusions: This study suggests the usefulness of 3D-CTA for the preoperative diagnosis of coronary ischemic disease in elderly lung cancer patients. Keywords: Aging, Coronary ischemic disease, Lung cancer, Surgery
Background The aging population is increasing in developed countries, including the United States, Canada and Australia as well as European countries, and the increase is even greater in Japan [1-3]. Although prolonged life expectancy is one of the biggest achievements of humankind, expansion of the oldest population also implies a rise in age-related diseases, including malignancies and cardiovascular disorders [1]. Among malignant diseases in the aging population, lung cancer is the leading cause of death in Japan and worldwide [4-6]. Patients with lung cancer have a poor prognosis, with only 15% of them being eligible for surgical resection [4,6]. Although the therapeutic response is limited, patients with advanced disease are usually treated with systemic chemotherapy or tyrosine inhibitors [4,6]. * Correspondence: [email protected] 4 Department of Immunology, Mie University Faculty and Graduate School of Medicine, Edobashi 2-174Mie 514-8507 Tsu City, Japan Full list of author information is available at the end of the article
In Japan, surgery is not usually indicated as a therapeutic option for the oldest group of lung cancer patients (older than 80years of age) because of poor performance status [7,8]. Because the performance status of some elderly groups with lung cancer has dramatically improved, aging is no longer an exclusion criterion for surgical intervention. However, the presence of concomitant diseases, such as emphysema, high blood arterial hypertension, coronary ischemic disease, cerebrovascular disorder
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