Pulmonary function is implicated in the prognosis of metastatic non-small cell lung cancer but not in extended disease small cell lung cancer

Abstract

Background: The impacts of pulmonary function in patients with metastatic non-small cell lung cancer (NSCLC) and extended disease stage small cell lung cancer (SCLC-ED) treated with palliative chemotherapy remain to still be determined. Methods: Results of spirometry performed in 449 patients with either stage IV NSCLC (n=313) or SCLC-ED (n=136) at diagnosis were reviewed retrospectively. Overall survival (OS) was estimated using the Kaplan-Meier method and compared via a log-rank test. Multivariate analysis was performed using a Cox proportional hazards regression model. Results: The presence of chronic obstructive pulmonary disease (COPD) was not a risk factor for OS in either NSCLC or SCLC. However, NSCLC patients with COPD with a forced expiratory volume in one second (FEV1) value of less than 80% predicted were associated with a worse OS in both univariate and multivariate analyses [hazard ratio (HR): 1.43; 95% confidence interval (CI): 1.04-1.97; P=0.03]. Intriguingly, only the OS of NSCLC patients treated with chemotherapeutic agents was affected by the airflow limitation FEV1 value of less than 80% predicted (P=0.02). Patients with an FEV1 value of less than 80% predicted treated with targeted agents were not associated with OS (P=0.24). On the other hand, NSCLC patients with COPD were significantly linked to the occurrence of pulmonary complications during palliative therapy (P=0.01) but not associated with death resulting from pulmonary complications (P=0.22). Conclusions: Careful attention is required when chemotherapeutic agents are administered to patients with metastatic NSCLC with accompanying COPD with a FEV1 value of less than 80% predicted.

Preoperative maximal voluntary ventilation, hemoglobin, albumin, lymphocytes and platelets predict postoperative survival in esophageal squamous cell carcinoma

“…Numerous studies have focused mainly on the prognostic value of preoperative pulmonary function in lung cancer but rarely in digestive cancers. These studies have clearly shown that preoperative pulmonary evaluation could be used as a predictor for postoperative complications and survival in lung cancer[ 9 , 23 ]. As described previously, FVC and VC have been demonstrated as predictors of postoperative complications and the survival in gastric cancer[ 10 ] and Japanese esophageal cancer[ 11 ], respectively.…”

“…Previous studies have shown that poor pulmonary function is associated with severe postoperative complications in patients undergoing esophagectomy[ 4 - 6 ]. Some studies have reported that reduced pulmonary function is associated with mortality risk in the general population[ 7 , 8 ], lung cancer[ 9 ] and gastric cancer[ 10 ], while little attention has been given to the correlation between preoperative pulmonary evaluation and the overall survival of esophageal cancer patients. Forced vital capacity (FVC) and vital capacity (VC) are both important parameters in pulmonary evaluation test.…”

Impact of coexistent preserved ratio impaired spirometry on the survival of patients with lung cancer: Analysis of data from the Korean Association for Lung Cancer Registry

“…This inconsistence can be attributed to the heterogeneity of the study population. 7 , 36 The lung cancer stage, pathology, and treatment of patients differ in each study; therefore, the effects of COPD may differ in studies with different populations. A number of studies have previously reported that COPD has a greater impact on early‐stage lung cancer than on advanced‐stage lung cancer.…”

Impact of COPD treatment on survival in patients with advanced non-small cell lung cancer

“…Similarly, in advanced NSCLC, several studies have reported that forced expiratory volume in 1 second (FEV 1 ) less than 50% predicted or the presence of COPD were associated with mortality [11][12][13]. Because severity of air ow obstruction and acute exacerbations are predictors of mortality in COPD patients [14][15][16], improving these factors might also be important in patients with advanced NSCLC and COPD.…”