Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-12-2015 | Thoracic Oncology

Surgical Outcomes of Lung Cancer in Patients with Combined Pulmonary Fibrosis and Emphysema

Authors: Takahiro Mimae, MD, PhD, Kenji Suzuki, MD, PhD, Masahiro Tsuboi, MD, PhD, Kanji Nagai, MD, PhD, Norihiko Ikeda, MD, PhD, Tetsuya Mitsudomi, MD, PhD, Hisashi Saji, MD, PhD, Sakae Okumura, MD, PhD, Meinoshin Okumura, MD, PhD, Kenichi Yoshimura, MD, PhD, Morihito Okada, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

Login to get access

Abstract

Purpose

Lung cancers in patients with combined pulmonary fibrosis and emphysema (CPFE) are increasing. Objective of this investigation was to identify which clinicopathological features significantly affected surgical outcome of these patients.

Methods

Among 4313 patients with primary lung cancers who underwent surgery between January 2008 and December 2010 in nine institutions in Japan, 265 had CPFE. We retrospectively compared 2176 and 157 patients without and with CPFE, respectively, and further analyzed 233 patients with CPFE whose detailed information was available. CPFE was defined as upper lobe emphysema and lower lobe fibrosis.

Results

The rates of postoperative morbidity and mortality were higher and overall survival was poorer in patients with, than without CPFE. Among 233 patients with CPFE, the median values of %VC and FEV1.0 % were 98.4 and 71.5 %, respectively. The histological types comprised 111 squamous cell carcinomas and 84 adenocarcinomas. Surgical procedures included 203 standard lobectomies/pneumonectomies and 30 lesser resections. Five patients (2 %) developed postoperative acute exacerbation of interstitial pneumonia. Six and 15 patients (3 and 6 %) died within 30- and 90-postoperative-day, respectively. Cancer was the cause of death at 90-day in only one patient. The 3-year overall survival rate for all patients was 58.4 %. Multivariate analysis showed that male sex, advanced age, advanced clinical stage and lower %VC predict a poor prognosis.

Conclusions

Patients with lung cancer and CPFE had poor prognoses regardless of apparently good pulmonary function and showed quite high postoperative mortality rates. A lower %VC that might reflect the severity of pulmonary fibrosis was associated with poor prognoses.
Appendix
Available only for authorised users
Literature
1.
2.
Cottin V, Nunes H, Brillet PY, et al. Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J. 2005;26(4):586–593.PubMedCrossRef
3.
4.
Congleton J, Muers MF. The incidence of airflow obstruction in bronchial carcinoma, its relation to breathlessness, and response to bronchodilator therapy. Respir Med. 1995;89(4):291–296.PubMedCrossRef
5.
Loganathan RS, Stover DE, Shi W, Venkatraman E. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest. 2006;129(5):1305-1312.PubMedCrossRef
6.
Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J. 2009;34(2):380–386.PubMedCrossRef
7.
Hubbard R, Venn A, Lewis S, Britton J. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med. 2000;161(1):5–8.PubMedCrossRef
8.
Kitaguchi Y, Fujimoto K, Hanaoka M, Kawakami S, Honda T, Kubo K. Clinical characteristics of combined pulmonary fibrosis and emphysema. Respirology. 2010;15(2):265–271.PubMedCrossRef
9.
Usui K, Tanai C, Tanaka Y, Noda H, Ishihara T. The prevalence of pulmonary fibrosis combined with emphysema in patients with lung cancer. Respirology. 2011;16(2):326–331.PubMedCrossRef
10.
11.
Girard N, Marchand-Adam S, Naccache JM, et al. Lung cancer in combined pulmonary fibrosis and emphysema: a series of 47 Western patients. J Thorac Oncol. 2014;9(8):1162–1170.PubMedCrossRef
12.
Kumagai S, Marumo S, Yamanashi K, et al. Prognostic significance of combined pulmonary fibrosis and emphysema in patients with resected non-small-cell lung cancer: a retrospective cohort study. Eur J Cardiothorac Surg. 2014;46(6):e113–e119.PubMedCrossRef
13.
Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2(8):706–714.PubMedCrossRef
14.
Mimae T, Tsutani Y, Miyata Y, et al. Role of lymphatic invasion in the prognosis of patients with clinical node-negative and pathologic node-positive lung adenocarcinoma. J Thorac Cardiovasc Surg. 2014;147(6):1820–1826.PubMedCrossRef
15.
16.
17.
Cottin V, Cordier JF. Combined pulmonary fibrosis and emphysema: an experimental and clinically relevant phenotype. Am J Respir Crit Care Med. 2005;172(12):1605; author reply 1605–1606.
18.
Inoue M, Okumura M, Sawabata N, et al. Clinicopathological characteristics and surgical results of lung cancer patients aged up to 50 years: the Japanese Lung Cancer Registry Study 2004. Lung Cancer. 2013.
19.
Kuwano H, Amano J, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2010: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2012;60(10):680–708.PubMedCrossRef
20.
Mimae T, Hagiyama M, Inoue T, et al. Increased ectodomain shedding of lung epithelial cell adhesion molecule 1 as a cause of increased alveolar cell apoptosis in emphysema. Thorax. 2014;69(3):223–231.PubMedPubMedCentralCrossRef
21.
Collard HR, King TE, Jr., Bartelson BB, Vourlekis JS, Schwarz MI, Brown KK. Changes in clinical and physiologic variables predict survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2003;168(5):538–542.PubMedCrossRef
22.
Triantafillidou C, Manali E, Lyberopoulos P et al. The role of cardiopulmonary exercise test in IPF prognosis. Pulm Med. 2013;2013:514817. doi:10.1155/2013/514817.PubMedPubMedCentralCrossRef
Metadata
Title
Surgical Outcomes of Lung Cancer in Patients with Combined Pulmonary Fibrosis and Emphysema
Authors
Takahiro Mimae, MD, PhD
Kenji Suzuki, MD, PhD
Masahiro Tsuboi, MD, PhD
Kanji Nagai, MD, PhD
Norihiko Ikeda, MD, PhD
Tetsuya Mitsudomi, MD, PhD
Hisashi Saji, MD, PhD
Sakae Okumura, MD, PhD
Meinoshin Okumura, MD, PhD
Kenichi Yoshimura, MD, PhD
Morihito Okada, MD, PhD
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4577-1

Other articles of this Special Issue 3/2015

Annals of Surgical Oncology 3/2015 Go to the issue

Breast Oncology

Back to Basics: Traditional Nottingham Grade Mitotic Counts Alone are Significant in Predicting Survival in Invasive Breast Carcinoma

Urologic Oncology

A Specific Cystography Pattern Can Predict Postprostatectomy Incontinence

Erratum

Erratum to: Bis Expression in Patients with Surgically Resected Lung Cancer and its Clinical Significance

Head and Neck Oncology

Usefulness of Magnetic Resonance Sialography for the Evaluation of Radioactive Iodine-Induced Sialadenitis

Thoracic Oncology

Oligo-Recurrence of Osteosarcoma Patients: Treatment Strategies for Pulmonary Metastases

Breast Oncology

Comparison of Post-injection Site Pain Between Technetium Sulfur Colloid and Technetium Tilmanocept in Breast Cancer Patients Undergoing Sentinel Lymph Node Biopsy