INTRODUCTION: The optimal surgical approach and the associated adverse outcomes in patients with lung cancer and heart disease remain unknown. This study was designed to explore the potential influence of simultaneous or staged surgery on the perioperative and oncological outcomes of these patients. MATERIALS AND METHODS: This retrospective study analyzed 158 patients who underwent cardiac and thoracic surgery between January 2016 and December 2021. The patients were divided into two groups according to the timing of surgery: simultaneous and staged. Perioperative and oncologic outcomes between the two groups were compared using 1:1 propensity score matching analysis and Kaplan-Meier analysis. RESULTS: In the 50 patients (72% male, mean age 60.9 ± 11.7 y) of the simultaneous surgery group, 10 (20%) developed tumor metastasis or recurrence and 6 (12%) died from tumor metastasis. In the staged surgery group, with 108 patients (75% male, mean age 66.1 ± 8.4 y), 18 (16.7%) developed tumor metastasis or recurrence, and 8 (7.4%) died. There was no significant difference in overall survival or progression-free survival between the groups. Compared with the staged surgery group, the simultaneous surgery group had a higher incidence of pulmonary infection (3.7% versus 18.0%
P = 0.002), longer operative time (173.9 ± 104.4 versus 295.6 ± 77.1 min
P <
0.001), increased intraoperative blood loss (89.2 ± 53.1 versus 386.0 ± 207.0 mL
P <
0.001), and a prolonged hospital stay (7.0 ± 3.1 versus 16.5 ± 6.1 d
P <
0.001). CONCLUSIONS: For patients with concurrent lung cancer and heart disease, staged surgery holds certain advantages when it comes to postoperative complications. Further researches are still needed to verify these findings.