Impact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer

Satô, Toshihiko; Teramukai, Satoshi; Kondo, Haruhiko; Watanabe, Atsushi; Ebina, Masahito; Kishi, Kazuma; Fujii, Yoshitaka; Mitsudomi, Tetsuya; Yoshimura, Masahiro; Maniwa, Tomohiro; Suzuki, Kenji; Kataoka, Kazuhiko; Sugiyama, Yukihiko; Kondo, Takashi; Date, Hiroshi

doi:10.1016/j.jtcvs.2013.09.050

Cited by 256 publications

(320 citation statements)

References 31 publications

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“…AE is an important negative prognostic factor for surgically resected lung cancer patients with interstitial lung disease (ILD). Sato et al (6) reported that AE occurred in 9.3% of surgically resected lung cancer patients with ILD, accounting for a mortality rate of 43.9%. They also identified the following independent risk factors for AE: Surgical procedures (wedge resection, lobectomy/segmentectomy, bilobectomy/pneumonectomy), male gender, history of exacerbation, pre-operative steroid use, elevated serum KL-6 levels (≥1,000 U/ml), appearance of UIP in the CT spectrum and reduced percentage of predicted vital capacity.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have indicated that CPFE patients have a significantly increased risk of lung cancer compared with patients with chronic obstructive pulmonary disease (COPD) or IPF alone (1,4,5). Post-operative acute exacerbation (AE) of interstitial lung disease in patients with lung cancer is associated with a high mortality rate (43.9%) (6). However, the clinical features and prognosis of patients with lung cancer and CPFE have remained elusive.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features and outcomes of patients with lung cancer as well as combined pulmonary fibrosis and emphysema

Otsuka

Sugino

Hata

et al. 2016

Molecular and Clinical Oncology

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Abstract. The syndrome of combined pulmonary fibrosis and emphysema (CPFE) has been characterized by severely impaired gas exchange and poor survival. However, the clinical features of patients with lung cancer plus CPFE have remained elusive. The present study performed a retrospective analysis to examine the clinical characteristics and outcome of surgically resected patients with lung cancer plus CPFE. Among 831 patients with primary lung cancer who underwent surgical resection, 23 patients (2.8%) were diagnosed with CPFE and 9 patients (1.1%) with solely idiopathic pulmonary fibrosis (IPF). Thirty-five patients were stratified as the solely emphysema group with adjustment of the pathological stage. The clinicopathological characteristics of patients in the CPFE group and their outcomes were evaluated and compared with those with the solely IPF or solely emphysema groups. Within the CPFE group, no significant differences in survival between patients with post-operative acute exacerbation (AE; n=3) and those without AE (n=20) were noted; however, in the solely IPF group, patients with post-operative AE (n=4) had a significantly shorter survival than those without AE (n=5; P=0.022). The 5-year survival rate of patients in the CPFE, solely IPF and solely emphysema groups was 22, 22 and 58%, respectively. Furthermore, the CPFE and solely IPF groups showed a significantly shorter survival than the solely emphysema group (P=0.001 and 0.011, respectively). In conclusion, surgically resected lung cancer patients with CPFE had poor survival, which was, in contrast to that of lung cancer patients with solely IPF, not affected by AE. IntroductionThe syndrome of combined pulmonary fibrosis and emphysema (CPFE) has been suggested to be a clinically important phenotype of pulmonary fibrosis (1). Cottin et al (1) defined CPFE as a distinct condition, with characteristic features in the chest computed tomography (CT) image that include emphysema in the upper pulmonary region concomitant with parenchymal fibrosis in the lower region. The syndrome is characterized by sub-normal spirometry, severely impaired gas exchange, high prevalence of pulmonary hypertension and poor survival (2-4). Mejía et al (3) reported that survival of CPFE patients was poorer compared with that of patients with idiopathic pulmonary fibrosis (IPF) alone and that pulmonary hypertension in CPFE patients was an independent predictor of mortality. Previous studies have indicated that CPFE patients have a significantly increased risk of lung cancer compared with patients with chronic obstructive pulmonary disease (COPD) or IPF alone (1,4,5). Post-operative acute exacerbation (AE) of interstitial lung disease in patients with lung cancer is associated with a high mortality rate (43.9%) (6). However, the clinical features and prognosis of patients with lung cancer and CPFE have remained elusive. The present study performed a retrospective analysis to determine the prevalence, clinical characteristics and outcome of patients with surgically resected lung canc...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical features and outcomes of patients with lung cancer as well as combined pulmonary fibrosis and emphysema

Otsuka

Sugino

Hata

et al. 2016

Molecular and Clinical Oncology

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“…Pathological assessment of IP in the resected lung was performed, if possible. A diagnosis of AE was made based on clinical and radiologic findings using previously presented criteria for postoperative AE [4]. Briefly, the criteria were (1) onset within 30 days after pulmonary resection, (2) intensified dyspnea, (3) increased interstitial shadows in chest radiograph and chest CT images, (4) decreased arterial oxygen tension greater than 10 Torr under similar conditions, (5) no evidence of pulmonary infection, and (6) exclusion of alternative causes, such as cardiac failure, pulmonary embolism, or other identifiable causes of lung injury.…”

Section: Methodsmentioning

confidence: 99%

“…Acute exacerbation (AE) in patients with idiopathic interstitial pneumonia (IP), mostly comprised of idiopathic pulmonary fibrosis cases is a potentially fatal postoperative complication following lung surgery [1][2][3][4][5][6]. Patients with IP comprise 4-5 % of those with lung cancer who undergo such an operation, while AE occurs in 9-15 % of patients with idiopathic IP undergoing lung cancer resection and the rate of mortality in those is approximately 50 % [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with IP comprise 4-5 % of those with lung cancer who undergo such an operation, while AE occurs in 9-15 % of patients with idiopathic IP undergoing lung cancer resection and the rate of mortality in those is approximately 50 % [4,5]. In Japan, AE is a major postoperative cause of death following lung resection, comprising 27.4 % of all perioperative mortality cases, while postoperative pyothorax (PP) and bronchopleural fistula (BPF) following lung cancer resection are the cause of perioperative death in 9.7 % of reported cases [7].…”

Section: Introductionmentioning

confidence: 99%

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Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection

Kobayashi

Karube

Nishihira

et al. 2016

Gen Thorac Cardiovasc Surg

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Intractable pneumothorax complicated with interstitial pneumonitis treated with the Tachosuture technique: A case report

Uchida

Matsubara

Sugimura

et al. 2018

Clinical Case Reports

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Impact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer

Cited by 256 publications

References 31 publications

Clinical features and outcomes of patients with lung cancer as well as combined pulmonary fibrosis and emphysema

Clinical features and outcomes of patients with lung cancer as well as combined pulmonary fibrosis and emphysema

Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection

Intractable pneumothorax complicated with interstitial pneumonitis treated with the Tachosuture technique: A case report

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