Lung cancer in connective tissue disease-associated interstitial lung disease: clinical features and impact on outcomes

Watanabe, Satoshi; Saeki, Keigo; Waseda, Yuko; Murata, Akari; Takato, Hazuki; Ichikawa, Yasumitsu; Yasui, Masahide; Kimura, Hideharu; Hamaguchi, Yasuhito; Matsushita, T.; Yamada, Kazunori; Kawano, Mitsuhiro; Furuichi, Kengo; Wada, Takashi; Kondo, Kazuo

doi:10.21037/jtd.2017.12.134

Cited by 23 publications

(21 citation statements)

References 32 publications

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“…We found a prevalence of lung cancer in 1.9% among non-IPF ILD patients. This appears to be lower than some previously published estimates [ 34 , 35 ], as well as a recent comprehensive study [ 36 ]. Thus, the molecular underpinnings of lung cancer risk in non-IPF ILD may be different than in IPF.…”

Section: Discussioncontrasting

confidence: 68%

Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

et al. 2018

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BackgroundLung Cancer is occasionally observed in patients with Idiopathic Pulmonary Fibrosis (IPF). We sought to describe the epidemiologic and clinical characteristics of lung cancer for patients with IPF and other interstitial lung disease (ILD) using institutional and statewide data registries.MethodsWe conducted a retrospective analysis of IPF and non-IPF ILD patients from the ILD center registry, to compare with lung cancer registries at the University of Pittsburgh as well as with population data of lung cancer obtained from Pennsylvania Department of Health between 2000 and 2015.ResultsAmong 1108 IPF patients, 31 patients were identified with IPF and lung cancer. The age-adjusted standard incidence ratio of lung cancer was 3.34 (with IPF) and 2.3 (with non-IPF ILD) (between-group Hazard ratio = 1.4, p = 0.3). Lung cancer worsened the mortality of IPF (p < 0.001). Lung cancer with IPF had higher mortality compared to lung cancer in non-IPF ILD (Hazard ratio = 6.2, p = 0.001). Lung cancer among IPF was characterized by a predilection for lower lobes (63% vs. 26% in non-IPF lung cancer, p < 0.001) and by squamous cell histology (41% vs. 29%, p = 0.07). Increased incidence of lung cancer was observed among single lung transplant (SLT) recipients for IPF (13 out of 97, 13.4%), with increased mortality compared to SLT for IPF without lung cancer (p = 0.028) during observational period.ConclusionsLung cancer is approximately 3.34 times more frequently diagnosed in IPF patients compared to general population, and associated with worse prognosis compared with IPF without lung cancer, with squamous cell carcinoma and lower lobe predilection. The causality between non-smoking IPF patients and lung cancer is to be determined.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0899-4) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 68%

Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

et al. 2018

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“…163 Additional risk factors include smoking history and emphysema. [164][165][166] Lung cancer is associated with a poor prognosis in CTD-ILD patients, partly owing to diagnosis at an advanced stage. 165 A pertinent issue with regard to oncologic management is the risk of acute exacerbation of the underlying ILD, with an incidence of 21.4% in one study of CTD-ILD patients.…”

Section: Malignancy In Ssc-ildmentioning

confidence: 99%

Systemic Sclerosis Associated Interstitial Lung Disease: A Comprehensive Overview

Mackintosh

Stainer

Barnett

et al. 2019

Semin Respir Crit Care Med

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Interstitial lung disease (ILD) is a common complication of systemic sclerosis (SSc). SSc-ILD adversely impacts quality of life and is currently the leading cause of death in this multisystem disease. Identifying clinically significant SSc-ILD is critically important. Accurate staging and prognostication remain difficult; however, significant advances have been made in the last decade. Evidence supports the need to treat patients with extensive and/or progressive SSc-ILD, while only a subset of patients with limited ILD may require treatment. Research is urgently required to allow improved prediction of patients at risk of ILD progression at an early point in the disease, and ideally prior to its onset, to allow prevention. The last decade has seen the publication of landmark clinical trials for SSc-ILD. More effective strategies with less toxicity are under investigation. For those with refractory or very advanced disease, studies into disease-specific palliative approaches are in their infancy. Lung transplantation as an option for SSc-ILD remains patient- and center-specific, with data to suggest equivalent outcomes to other fibrotic lung diseases, in carefully selected cases. This review aims to provide a comprehensive overview of all key aspects of SSc-ILD.

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“…Renal involvement as concomitant manifestation was present mostly in patients with SLE and in 16 patients with vasculitis, renal failure confirmed generalized form of disease [16].Three patients with collagen vascular diseases at time of analysis had diagnosed carcinoma but none had lung carcinoma. Connective tissue disease represents a large group of disease, which can be associated with carcinoma of different localizations, and most frequently with breast and lung cancers [5,14]. Risk factors for lung cancer development in connective tissue disease are still the subject of basic research.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Risk factors for lung cancer development in connective tissue disease are still the subject of basic research. The effects of immunosuppressive therapy on cancer risk remain controversial [5].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Although pulmonary complications generally occur in patients with well-established disease, lung involvement can be the first manifestation of an autoimmune disorder. Patients with CVD are at higher risk of various malignancies, and the most frequent are breast and lung cancer, the latter most commonly detected at an advanced stage [1,5]. Therefore, both the general practitioner and specialist should have a broad knowledge of the SAD and their complications because identification of these manifestations may initiate earlier treatment and, possibly, better disease outcome.…”

Section: Introductionmentioning

confidence: 99%

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Pleuropulmonary manifestations of systemic autoimmune diseases: An 84-case series analysis

et al. 2020

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Introduction/Objective. The systemic autoimmune diseases (SAD) can cause a variety of pulmonary and pleural abnormalities. The aim of this paper is to review clinical and radiological characteristics of a series of patients with systemic autoimmune disease hospitalized at a tertiary level facility. Methods. In this retrospective study, we reviewed the clinical and imaging findings in patients diagnosed with SAD at the Teaching Hospital of Pulmonology during a nine-year period. Results. The 84 patients group (mean age of 53.8 years) consisted of 64 women and 20 men. Fifty-eight out of 84 patients suffered from collagen vascular disease (CVD) and 26/84 had systemic vasculitis. Fatigue was a dominant symptom (75.8% in CVD, and 69.2% in vasculitis). Cough, hemoptysis, and fever were more frequent in patients with vasculitis. Fibrosis was the most common radiological manifestation of CVD (26/58), followed by pleural effusion (18/58) and consolidation (10/58). Irregular opacities were dominant radiologic finding in vasculitis (10/26), followed by nodules (8/26). Histological confirmation of systemic autoimmune disease was obtained in 28.6% patients, in 58/84 patients the diagnosis was based on positive serologic test and clinico-radiological manifestations, in two cases, on clinical and radiological features according to defined criteria. Conclusion. Pleuropulmonary manifestations of systemic autoimmune diseases are usually expressed in the sixth decade of age, predominantly in women. Clinical findings and positive serologic tests suggest diagnosis of systemic autoimmune diseases. Fibrosis is the most common radiologic pattern found in almost a half of the patients with CVD and irregular opacities are most common findings in vasculitis. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175046]

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Lung cancer in connective tissue disease-associated interstitial lung disease: clinical features and impact on outcomes

Cited by 23 publications

References 32 publications

Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data

Systemic Sclerosis Associated Interstitial Lung Disease: A Comprehensive Overview

Pleuropulmonary manifestations of systemic autoimmune diseases: An 84-case series analysis

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