Impact of Chronic Obstructive Pulmonary Disease on Risk of Recurrence in Patients with Resected Non-small Cell Lung Cancer.
10.3779/j.issn.1009-3419.2018.03.21
- VernacularTitle:慢性阻塞性肺疾病对非小细胞肺癌术后复发风险的影响
- Author:
Guangliang QIANG
1
;
Qiduo YU
1
;
Chaoyang LIANG
1
;
Zhiyi SONG
1
;
Bin SHI
1
;
Yongqing GUO
1
;
Deruo LIU
1
Author Information
1. Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
- Publication Type:Journal Article
- Keywords:
Chronic obstructive pulmonary disease;
Lung neoplasms;
Prognosis;
Pulmonary function;
Surgery
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Carcinoma, Non-Small-Cell Lung;
complications;
mortality;
physiopathology;
surgery;
Female;
Humans;
Lung Neoplasms;
complications;
mortality;
physiopathology;
surgery;
Male;
Middle Aged;
Multivariate Analysis;
Pulmonary Disease, Chronic Obstructive;
complications;
mortality;
physiopathology;
Respiratory Function Tests;
Retrospective Studies
- From:
Chinese Journal of Lung Cancer
2018;21(3):215-220
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Lung cancer and chronic obstructive pulmonary disease (COPD) are both common diseases in respiratory system and the leading causes of deaths worldwide. The purpose of this study was to determine whether the severity of COPD affects long-term survival in non-small cell lung cancer (NSCLC) patients after surgical resection.
METHODS:A retrospective research was performed on 421 consecutive patients who had undergone lobectomy for NSCLC. Classification of COPD severity was based on guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Characteristics among the three subgroups were compared and recurrence-free survivals were analyzed.
RESULTS:A total of 172 patients were diagnosed with COPD, 124 as mild (GOLD-1), 46 as moderate(GOLD-2), and 2 as severe (GOLD-3). The frequencies of recurrence were significantly higher in higher COPD grades group (P<0.001). Recurrence-free survival at five years were 78.1%, 70.4%, and 46.4% in Non-COPD, GOLD-1 COPD, and GOLD-2/3 COPD groups, respectively (P<0.001). In univariate analysis, age, gender, smoking history, COPD severity, tumor size, histology and pathological stage were associated with recurrence-free survival. Multivariate analyses showed that older age, male, GOLD-2/3 COPD, and advanced stage were independent risk factors associated with recurrence-free survival.
CONCLUSIONS:NSCLC patients with COPD are at higher risk for postoperative recurrence, and moderate/severe COPD is an independent unfavorable prognostic factor. The severity of COPD based on pulmonary function test can be a useful indicator to identify patients at high risk for recurrence. Therefore, it can contribute to adequate selection of the appropriate individualized treatment.
