The Impact of Coexisting COPD on Survival of Patients With Early-Stage Non-small Cell Lung Cancer Undergoing Surgical Resection

Zhai, Rihong; Yu, Xiaofang; Shafer, Andrea T.; Wain, John C.; Christiani, David C.

doi:10.1378/chest.13-1176

Cited by 115 publications

(122 citation statements)

References 43 publications

(51 reference statements)

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“…Severe COPD was not associated with increased 1-year mortality, but after 2 and 5 years, these patients had increased mortality compared to patients with normal lung function and mild to moderate COPD. These results demonstrating the long-term mortality of patients with severe COPD are in accordance with comparable studies [59,60]. In addition, the coinciding results supports the external validity and generalizability of our study.…”

Section: Discussion Of Main Resultssupporting

confidence: 92%

Survival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease

Bugge

Lund

Brunborg

et al. 2016

The Annals of Thoracic Surgery

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Section: Discussion Of Main Resultssupporting

confidence: 92%

Survival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease

Bugge

Lund

Brunborg

et al. 2016

The Annals of Thoracic Surgery

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“…Severe COPD increases the risk of postoperative complications and reduces the extent of the lung that can be safely resected [21,22,23]. In studies focusing on resected patients with early NSCLC, coexisting COPD was associated with poorer survival outcome in comparison to those without COPD [23,24]. In addition, it is well known that the prevalence rates of lung cancer and COPD increase with age [21,25].…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopy-Guided Cooled Radiofrequency Ablation as a Novel Intervention Therapy for Peripheral Lung Cancer

Koizumi¹,

Tsushima

Tanabe

et al. 2015

Respiration

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Background: Our previous animal and preliminary human studies indicated that bronchoscopy-guided cooled radiofrequency ablation (RFA) for the lung is a safe and feasible procedure without major complications. Objectives: The present study was performed to evaluate the safety, effectiveness and feasibility of computed tomography (CT)-guided bronchoscopy cooled RFA in patients with medically inoperable non-small-cell lung cancer (NSCLC). Methods: Patients with pathologically diagnosed NSCLC, who had no lymph node involvement or distant metastases (T1-2aN0M0) but were not surgical candidates because of comorbidities (e.g. synchronous multiple nodules, advanced age, cardiovascular disease, poor pulmonary function, etc.) were enrolled in the present study. The diagnosis and location between the nearest bronchus and target tumor were made by CT-guided bronchoscopy before the treatment. A total of 28 bronchoscopy-guided cooled RFA procedures were performed in 20 patients. After treatment, serial CT imaging was performed as follow-up. Results: Eleven lesions showed significant reductions in tumor size and 8 lesions showed stability, resulting in a local control rate of 82.6%. The median progression-free survival was 35 months (95% confidence interval: 22-45 months), and the 5-year overall survival was 61.5% (95% confidence interval: 36-87%). Three patients developed an acute ablation-related reaction (fever, chest pain) and required hospitalization but improved with conservative treatment. There were no other adverse events in the present study. Conclusions: CT-guided bronchoscopy cooled RFA is applicable for only highly selected subjects; however, our trial may be an alternative strategy, especially for disease local control in medically inoperable patients with stage I NSCLC.

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“…A retrospective study by Sekine et al reported an increased rate of postoperative complications, including pneumonia and the need for a tracheostomy, increased cancer recurrence, and a decreased 5-year survival rate in patients with completely resected stage IA nonsmall cell lung cancer (NSCLC) and coexisting COPD; the 5-year survival rates of patients with COPD (n = 80) and of those without COPD (n = 362) were 77.0% and 91.6%, respectively (P = 0.0001) [52] . A recent retrospective study involving 902 patients with stage IA to IIB NSCLC treated with surgical resection also disclosed that 63.4% (572/902) of the patient population had self-reported, physician-diagnosed COPD, and the patients with COPD had a poorer 5-year progression-free survival rate (50.1% vs 60.6%, P = 0.007) and a poorer 5-year overall survival rate (54.4% vs 69.0%, P = 0.0002) than the patients without COPD [53] .…”

Section: Prognosismentioning

confidence: 96%

Chronic obstructive pulmonary disease as a risk factor for lung cancer

Takiguchi

Sekine

Iwasawa

et al. 2014

WJCO

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The association between chronic obstructive pulmonary disease (COPD) and lung cancer has long been a subject of intense debate. The high prevalence of COPD in elderly smokers inevitably strengthens their coincidence. In addition to this contingent coincidence, recent studies have revealed a close association between the two diseases that is independent of the smoking history; that is, the existence of COPD is an independent risk factor for the development of lung cancer. Molecular-based evidence has been accumulating as a result of the efforts to explain the underlying mechanisms of this association. These mechanisms may include the following: the retention of airborne carcinogens followed by the activation of oncogenes and the suppression of tumor suppressor genes; the complex molecular mechanism associated with chronic inflammation in the distal airways of patients with COPD; the possible involvement of putative distal airway stem cells; and genetic factors that are common to both COPD and lung cancer. The existence of COPD in patients with lung cancer may potentially affect the process of diagnosis, surgical resection, radiotherapy, chemotherapy, and end-of-life care. The comprehensive management of COPD is extremely important for the appropriate treatment of lung cancer. Surgical resections with the aid of early interventions for COPD are often possible, even for patients with mild-to-moderate COPD. New challenges, such as lung cancer CT screening for individuals at high risk, are now in the process of being implemented. Evaluating the risk of lung cancer in patients with COPD may be warranted in community-based lung cancer screening.

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The Impact of Coexisting COPD on Survival of Patients With Early-Stage Non-small Cell Lung Cancer Undergoing Surgical Resection

Cited by 115 publications

References 43 publications

Survival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease

Survival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease

Bronchoscopy-Guided Cooled Radiofrequency Ablation as a Novel Intervention Therapy for Peripheral Lung Cancer

Chronic obstructive pulmonary disease as a risk factor for lung cancer

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