LAUSR

At present, for the surgical treatment of with NSCLC in patients with severe forms of ischemic heart disease (IHD), one-stage myocardial revascularization and lung resection are used, as well as staged operations where cardiac surgery precedes lung operations with an interval of several weeks. Regarding this category of patients, the appropriate tactics of surgical treatment is a debatable subject. Objective: to substantiate the use of two-stage treatment of patients NSCLC and IHD requiring coronary artery bypass grafting (CABG). Materials and Methods: Two comparable (Mann-Whitney) groups of 24 patients operated on for NSCLC were studied. In group A, surgery for NSCLC was performed in the second stage after CABG. In group B all patients did not have IHD. Disease free and Overall Survival (DFS and OS) rates in groups were evaluated using Kaplan-Meier method. The factors affecting survival rates were determined by univariate and multivariate (Cox) analysis. Results: The number of postoperative complications in both groups was comparable: 20.8% in patients undergoing CABG and 16.6% in those operated on only for NSCLC. The rates of DFS and OS in the groups did not differ significantly (p = 0.90 and p = 0.95). Median of OS in group A was 35 month, in group B – 34. Only the stage of the disease (p = 0.009) and complex oncological treatment, if necessary (p = 0.035), had an impact on the long-term results. CABG at the first stage did not affect the results of treatment. Conclusions: A two-stage treatment of NSCLC in critical forms of IHD, requiring myocardial revascularization, is appropriate and reliable, and does not affect the long-term results of treatment.