• Thorac Cardiovasc Surg · Sep 2009

    Long-term surgical outcome in patients with lung cancer and coexisting severe COPD.

    • T Nakajima, Y Sekine, Y Yamada, H Suzuki, K Yasufuku, S Yoshida, M Suzuki, K Shibuya, T Fujisawa, and I Yoshino.
    • Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
    • Thorac Cardiovasc Surg. 2009 Sep 1;57(6):339-42.

    BackgroundThe 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.MethodsBetween 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.ResultsThe 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.ConclusionPatients 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.Georg Thieme Verlag KG Stuttgart New York.

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