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DOI: 10.1055/s-0029-1185571
© Georg Thieme Verlag KG Stuttgart · New York
Long-term Surgical Outcome in Patients with Lung Cancer and Coexisting Severe COPD
Publikationsverlauf
received January 27, 2009
Publikationsdatum:
25. August 2009 (online)
![](https://www.thieme-connect.de/media/thoracic/200906/lookinside/thumbnails/10.1055-s-0029-1185571-1.jpg)
Abstract
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.
Key words
lung cancer surgery - perioperative care - chronic obstructive pulmonary disease - long‐term survival - interstitial pneumonia
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MD, PhD Yasuo Sekine
Department of Respiratory and Vascular Surgery
Tokyo Women's Medical University Yachiyo Medical Center, Chiba
477-96 Owadashinden
Yachiyo City, Chiba
Japan 276-8524
Telefon: + 81 4 74 50 60 00
Fax: + 81 4 32 26 21 72
eMail: ysekine@tymc.twmu.ac.jp