Document Detail

Long-term surgical outcome in patients with lung cancer and coexisting severe COPD.
MedLine Citation:
PMID:  19707975     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The functional criteria for curative surgery for patients with non-small cell lung cancer (NSCLC) and coexisting chronic obstructive pulmonary disease (COPD) remain controversial. We aimed to clarify long-term outcomes after resection. METHODS: Between January 1990 and April 2005, 36 consecutive patients with NSCLC and severe COPD underwent pulmonary resection. All had severe (30-50 % pred FEV1) or very severe COPD (30 % > pred FEV1) preoperatively. Survival, short- and long-term complications were analyzed retrospectively. Prognostic factors were also analyzed. RESULTS: The 5-year survival rate of these patients was significantly worse than that of patients with better pulmonary function (50 % < pred FEV1) ( P < 0.0001). Patients with interstitial pneumonia (IP) had a significantly poorer prognosis ( P = 0.0099). With regard to long-term complications three months after surgery, 30 % of patients reported worsening of dyspnea, and 20 % experienced pneumonia recurrence. No deaths were related to COPD progression. CONCLUSION: Patients with stage IA NSCLC and severe COPD may undergo curative surgical resection; however, postoperative complications and long-term survival remain unsolved problems. IP is a contraindication for surgery in patients with severe COPD.
T Nakajima; Y Sekine; Y Yamada; H Suzuki; K Yasufuku; S Yoshida; M Suzuki; K Shibuya; T Fujisawa; I Yoshino
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Publication Detail:
Type:  Journal Article     Date:  2009-08-25
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  57     ISSN:  1439-1902     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  339-42     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart New York.
Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
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MeSH Terms
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / complications,  mortality,  physiopathology,  surgery*
Dyspnea / etiology
Forced Expiratory Volume
Kaplan-Meiers Estimate
Lung Diseases, Interstitial / complications
Lung Neoplasms / complications,  mortality,  physiopathology,  surgery*
Lymph Node Excision
Middle Aged
Neoplasm Staging
Patient Selection
Pneumonectomy* / adverse effects,  contraindications,  mortality
Pulmonary Disease, Chronic Obstructive / complications*,  mortality,  physiopathology
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult

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