Risk Assessment of Perioperative Mortality After Pulmonary Resection for Primary Lung Cancer: the 30-day or 90-day Mortality

━━ Objective. Thirty-day mortality is adapted to the evaluation of perioperative mortality following pulmonary resection of primary lung cancer. However, whether 90-day mortality adequately evaluates perioperative mortality remains unknown. In this study, we analyzed the 30- and 90-day mortality following pulmonary resection of primary lung cancer at our institution. Methods. A total of 2207 pulmonary resections of primary lung cancer performed between 1996 and 2010 at Aichi Cancer Center Hospital were analyzed and divided into two groups of almost equal number: the early period (1070 patients treated between 1996 and 2004) and the late period (1137 patients treated between 2005 and 2010). Sixty-six and 34 postoperative deaths occurred within one year during the early and late periods, respectively. The causes of death (recurrence, bleeding, sudden death, respiratory failure and adverse events of chemotherapy) and 30- and 90-day mortality rates were investigated. Results. The 30- and 90-day mortality rates were 0.56％ and 0.35％, respectively, during the early period and 0.75％ and 0.79％, respectively, during the late period. Among the patients who died within one year after undergoing pulmonary resection, the postoperative survival of the patients with death due to recurrence (75 patients) and death due to bleeding or sudden death (seven patients) was ＞91 days and ＜30 days, respectively. The postoperative survival of the patients with death due to bleeding or sudden death (seven patients) was ＜30 days. The me-dian postoperative survival of the patients with respiratory failure was 67 days (range: 20-142 days) in the early period and 100 days (range: 47-149 days) in the late period. In the late period, adequately assessing perioperative mortality using 30-day mortality was difficult due to pulmonary complications. Conclusions. A risk assessment of perioperative mortality following pulmonary resection of primary lung cancer should be performed using 90- and 30-day mortality.