Pulmonary atelectasis and survival in advanced non-small cell lung carcinoma

Abstract

Atelectasis was reported as a favorable prognostic sign of pulmonary carcinoma; however, the underlying mechanism in those patients is not known. In this study, we aimed to investigate prospectively the potential impact of atelectasis and/or obstructive pneumonitis (AO) on survival and the relation between atelectasis and some laboratory blood parameters. The study was conducted on 87 advanced stage non-small cell lung cancer (NSCLC) patients. Clinical and laboratory parameters of patients at first presentation were recorded, and patients were divided into two groups according to the presence of AO in thorax computed tomography (CT). Survival was calculated using Kaplan-Meier and univariate Cox's regression analyses. Laboratory parameters that might be related with prolonged survival in atelectasis were compared using chi-square, Student's t, and Mann-Whitney U tests. Of the patients, 54% had stage IV disease, and AO was detected in 48.3% of all cases. Overall median survival was 13.2 months for all cases, 10.9 months for patients without AO, and 13.9 months for patients with AO (P = 0.067). Survival was significantly longer in stage III patients with AO (14.5 months versus 9.2 months, P = 0.032), but not in stage IV patients. Patients with AO in stage III had significantly lower platelet counts (P = 0.032) and blood sedimentation rates than did those with no AO (P = 0.045). We concluded that atelectasis and/or obstructive pneumonitis was associated with prolonged survival in locally advanced NSCLC. There was also a clear association between atelectasis and/or obstructive pneumonitis and platelets and blood sedimentation rate.

Prognostic effects of preoperative obstructive pneumonitis or atelectasis and comparison with tumor size in non-small cell lung cancer

“…Ou et al's study once confirmed that visceral pleura invasion, hilar atelectasis, or obstructive pneumonitis with tumor size >3 cm were poor prognostic factors for survival, but they predicted favorable prognosis when tumor size ≤3 cm (15). Besides, Dediu and Bulbul et al's articles showed the positive prognostic value of obstructive pneumonitis/atelectasis in patients with advanced lung cancer (16,17). They thought the favorable effect of atelectasis might owe to the decreased intratumoral blood flow and a specific growth pattern.…”

Prognostic factors for overall survival of stage III non-small cell lung cancer patients on computed tomography: A systematic review and meta-analysis

“…These studies yielded a total of 26 unique CT-related prognostic factors. Most studies had a retrospective cohort study design; nine studies reported a prospective cohort study design [14,20,[31][32][33][34][35][36][37]. In studies reporting follow-up duration, median follow-up ranged from 10 to 70.8 months.…”

“…Thirty inclusions explicitly stated using a clinical staging method [12,14,16,21,31,33,36,, while a combination of clinical and pathological staging was used in 3 studies [61][62][63]. The remaining 32 studies did not specify the staging method [11,13,15,17,18,20,32,34,35,37,. More recent staging systems TNM6 (2002, n = 9), TNM7 (2009, n = 23), and TNM8 (2017, n = 3) were used in 35 publications [11-13,15,16,33, 35,36,38,39,42,46,47,49,51,52,54-57,59,61-63,65,66,68,72,73,75,7 6,78,80,81,85].…”

“…CT, typically used to obtain information on tumor size and location, is integral for determination of clinical T-stage and N-stage [9,10]. In recent years an abundance of articles considering factors for overall survival (OS) that can be measured by CT has been published [11][12][13][14][15][16][17][18][19][20][21]. In order for these CT-related prognos-…”

Diagnóstico diferencial de hemitórax opaco en radiografía simple: Reporte de un Caso Clínico

“…Las atelectasias son una condición común en pacientes con cáncer de pulmón, éstas se desarrollan usualmente por obstrucción endobronquial, y menos frecuente, por compresión causada por el tumor o derrame pleural (Bulbul et al, 2010).…”