Author of

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

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    P1.07-001 - The impact of combined pulmonary fibrosis and chronic obstructive pulmonary disease on long-term survival after lung cancer surgery (ID 121)

    09:30 - 09:30  |  Author(s): E. Koh
    • Abstract

    Background
    The purpose of this study was to determine the impact of pulmonary fibrosis on postoperative complications and on long-term survival after surgical resection in lung cancer patients with chronic obstructive pulmonary disease.

    Methods
    A retrospective chart review was conducted of 380 patients with chronic obstructive pulmonary disease who had undergone pulmonary resection for lung cancer at Chiba University Hospital between 1990 and 2005. The definition of chronic obstructive pulmonary disease was a preoperative forced expiratory volume in one second /forced vital capacity ratio of less than 70%; pulmonary fibrosis was defined as obvious bilateral fibrous change in the lower lung fields, confirmed by computed tomography. Statistical comparisons were carried out between the groups, and multiple logistic regression analysis was used to evaluate for independent risk factors for decreased survival.

    Results
    Pulmonary fibrosis was present in 41 patients (10.8%) with chronic obstructive pulmonary disease; the remaining 339 patients (89.2%) did not have pulmonary fibrosis. The preoperative forced vital capacity and forced expiratory volume in one second were significantly lower in patients in the group with pulmonary fibrosis than in the group without (p < 0.05). Acute lung injury and home oxygen therapy were significantly more common in the pulmonary fibrosis group; however, the 30-day mortality was similar between the groups. The cumulative survival at 3 and 5 years was 53.6% and 36.9% in the pulmonary fibrosis group and 71.4% and 66.1% in the non-pulmonary fibrosis group (p = 0.0009). The group without pulmonary fibrosis had significantly better survival, due to a lower rate of cancer recurrence. Increased age, decreased body mass index, advanced pathologic stage and the existence of pulmonary fibrosis were identified as independent risk factors for decreased survival.

    Conclusion
    Pulmonary fibrosis is a risk factor for decreased survival after surgical treatment in lung cancer patients with chronic obstructive pulmonary disease.