Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12526

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    P3.07-031 - Surgical Outcome of Resected Lung Cancer Patients Complicated with Combined Pulmonary Fibrosis and Emphysema (ID 2348)

    09:30 - 09:30  |  Author(s): M. Fukui
    • Abstract

    Background
    Combined pulmonary fibrosis and emphysema (CPFE) has been recently reported as a prognostic factor for patient with respiratory disorders. It might increase the risk of lung cancer. However controversisies remain as to surgical outcome in this population.

    Methods
    Retrospective study was performed on 981 patients who underwent surgical resection of lung cancer at our institute between 2008 and 2012. Findings on thin-section computed tomography which was available for all patients were reviewed. Based on the findings, patients complicated with CPFE were selected and clinicopathological features were investigated. Surgical outcome and prognosis following lung resection were also examined.

    Results
    CPFE was observed in 97 (9.1%) patients with resected lung cancer.　Patients with pulmonary fibrosis alone were 43 patients (43.8%), patients with emphysema alone were 148 patients (15.1%) and patients without abnormal shadow were 649 patients. Lung function test were as follows (CPFE/ Fibrosis/ Emphysema): vital capacity (VC); 3.3L/ 2.9L/ 3.5L, forced expiratory volume in one second (FEV1); 71.5%/ 77.4%/ 67.9%, diffuse capacity (DLco); 44.6%/ 58.1%/ 58.6%. Ninety day-mortality(CPFE/ Fibrosis/ Emphysema) was 10.2%/ 2.3%/ 1.1%. Risk factor of ninety day mortality in patients with CPFE was operative blood loss. CPFE patients also have higher risk of major complication after surgery (CPFE 44.3%, non-CPFE 8.1%). The statistically significant difference in survival was found with the Kaplan-Meier method (p<0.001). Survival at 2 years(CPFE/ Fibrosis/ Emphysema/ Normal) was 74.6%/ 88.2%/ 91.4%/ 93.6% and survival at 5 years (CPFE/ Fibrosis/ Emphysema/ Normal) was 58.6% /61.8% /72.9%/ 81.5%. Within CPFE patients, multivariable analysis of hazard ratio for prognosis showed following significant factors; pO2<70 (HR 13.52, p=0.001), lymph node metastasis (HR 10.89, p=0.002).

    Conclusion
    Surgery for patients with CPFE is feasible. Postoperative complications were frequently and prognosis is poor compared with either emphysema or fibrosis. Not only the status of lung cancer but also respiratory status is a risk factor of prognosis after surgery for primary lung cancer with CPFE.