• Shogo Kumagai, Satoshi Marumo, Keiji Yamanashi, Junko Tokuno, Yuichiro Ueda, Tsuyoshi Shoji, Takafumi Nishimura, Cheng-Long Huang, and Motonari Fukui.
• Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
• Eur J Cardiothorac Surg. 2014 Dec 1; 46 (6): e113-9.

ObjectivesCombined pulmonary fibrosis and emphysema (CPFE) is a unique disorder that is usually diagnosed on the basis of high resolution computed tomography (HRCT) findings. It is unclear whether CPFE is an independent prognostic factor in patients with non-small-cell lung cancer (NSCLC). Therefore, we conducted a retrospective analysis to assess the impact of CPFE on the prognosis of patients with completely resected NSCLC.MethodsWe retrospectively reviewed 365 patients diagnosed with NSCLC who underwent complete resection at the Tazuke Kofukai Medical Research Institute, Kitano Hospital between January 2007 and December 2012. Patients were classified into four groups according to chest HRCT findings: those with CPFE, those with fibrosis, those with emphysema or those with a normal lung except for the presence of a tumour. We evaluated disease-free survival (DFS) and overall survival (OS) using the two-tailed log-rank test and the Cox proportional hazards model.ResultsThe two-tailed log-rank test demonstrated that the four groups had significantly different DFS and OS (P < 0.01). In the multivariate analysis, CPFE was found to be an independent prognostic factor for DFS and OS compared with a normal lung [hazard ratio (HR): 2.52; 95% confidence interval (CI): 1.24-5.13; P = 0.01 and HR: 4.53; 95% CI: 1.91-10.7; P < 0.01, respectively].ConclusionsCPFE is a significant, unfavourable prognostic factor for NSCLC patients after curative resection.© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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