Skip to main content
Top
Published in: International Journal of Clinical Oncology 4/2019

01-04-2019 | Original Article

Prognostic impact of underlying lung disease in pulmonary wedge resection for lung cancer

Authors: Takeshi Kawaguchi, Noriyoshi Sawabata, Sachiko Miura, Norikazu Kawai, Motoaki Yasukawa, Takashi Tojo, Shigeki Taniguchi

Published in: International Journal of Clinical Oncology | Issue 4/2019

Login to get access

Abstract

Background

Pulmonary wedge resection is an option for lung cancer patients with limited cardiopulmonary preservation. As the impact of underlying lung status on the prognosis of such patients remains unclear, we assessed this issue.

Methods

A total of 149 borderline surgical candidates with localized lung cancer who had undergone wedge resection were retrospectively investigated. Clinical variables related to perioperative morbidity, local control rate, and oncological outcomes based on underlying lung disease were analyzed.

Results

According to the risk analysis of postoperative complications, underlying lung disease did not influence the surgical morbidity. Postoperative recurrence occurred in 65 patients (locoregional recurrence in 36, distant metastasis in 12, and both simultaneously in 17). Multivariate analysis revealed that emphysema on computed tomography (CT) [hazard ratio (HR) 0.45; 95% confidence interval (CI) 0.21–0.99] was an independent indicator of locoregional recurrence. Forty-four patients died of lung cancer and 29 of other causes. Multivariate analysis demonstrated that interstitial lung disease on CT (HR 1.98; 95% CI 1.01–3.89) was a predictor of poor prognosis.

Conclusion

Pulmonary wedge resection can be safely undergone by lung cancer patients regardless of pulmonary comorbidity, although underlying lung disease may influence the prognosis after wedge resection.
Literature
1.
go back to reference El-Sherif A, Gooding WE, Santos R et al (2006) Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg 82:408–416CrossRefPubMed El-Sherif A, Gooding WE, Santos R et al (2006) Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg 82:408–416CrossRefPubMed
2.
go back to reference Dziedzic R, Żurek W, Marjański T et al (2017) Stage I non-small-cell lung cancer: long-term results of lobectomy versus sublobar resection from the Polish national lung cancer registry. Eur J Cardiothorac Surg 52:363–369CrossRefPubMed Dziedzic R, Żurek W, Marjański T et al (2017) Stage I non-small-cell lung cancer: long-term results of lobectomy versus sublobar resection from the Polish national lung cancer registry. Eur J Cardiothorac Surg 52:363–369CrossRefPubMed
4.
go back to reference Iwata H, Murakami M, Demizu Y et al (2010) High-dose proton therapy and carbon-ion therapy for stage I nonsmall cell lung cancer. Cancer 116:2476–2485PubMed Iwata H, Murakami M, Demizu Y et al (2010) High-dose proton therapy and carbon-ion therapy for stage I nonsmall cell lung cancer. Cancer 116:2476–2485PubMed
5.
go back to reference Crabtree T, Puri V, Timmerman R et al (2013) Treatment of stage I lung cancer in high-risk and inoperable patients: comparison of prospective clinical trials using stereotactic body radiotherapy (RTOG0236), sublobar resection (ACOSG Z4032), and radiofrequency ablasion (ACOSOG Z4033). J Thorac Cardiovasc Surg 145:692–699CrossRefPubMed Crabtree T, Puri V, Timmerman R et al (2013) Treatment of stage I lung cancer in high-risk and inoperable patients: comparison of prospective clinical trials using stereotactic body radiotherapy (RTOG0236), sublobar resection (ACOSG Z4032), and radiofrequency ablasion (ACOSOG Z4033). J Thorac Cardiovasc Surg 145:692–699CrossRefPubMed
6.
go back to reference Ueki N, Matsuo Y, Togashi Y et al (2015) Impact of pretreatment interstitial lung disease on radiation pneumonitis and survival after stereotactic body radiation therapy for lung cancer. J Thorac Oncol 10:116–125CrossRefPubMed Ueki N, Matsuo Y, Togashi Y et al (2015) Impact of pretreatment interstitial lung disease on radiation pneumonitis and survival after stereotactic body radiation therapy for lung cancer. J Thorac Oncol 10:116–125CrossRefPubMed
7.
go back to reference Zheng A, Wang X, Yang X et al (2014) Major complications after lung microwave ablation: a single-center experience on 204 sessions. Ann Thorac Surg 98:243–248CrossRefPubMed Zheng A, Wang X, Yang X et al (2014) Major complications after lung microwave ablation: a single-center experience on 204 sessions. Ann Thorac Surg 98:243–248CrossRefPubMed
8.
go back to reference Sawabata N, Ohta M, Matsumura A et al (2004) Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study. Ann Thorac Surg 77:415–420CrossRefPubMed Sawabata N, Ohta M, Matsumura A et al (2004) Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study. Ann Thorac Surg 77:415–420CrossRefPubMed
9.
go back to reference Sawabata N (2013) Locoregional recurrence after pulmonary sublobar resection of non-small cell lung cancer: can it be reduced by considering cancer cells at the surgical margin? Gen Thorac Cardiovasc Surg 61:9–16CrossRefPubMed Sawabata N (2013) Locoregional recurrence after pulmonary sublobar resection of non-small cell lung cancer: can it be reduced by considering cancer cells at the surgical margin? Gen Thorac Cardiovasc Surg 61:9–16CrossRefPubMed
10.
go back to reference Mohiuddin K, Haneuse S, Sofer T et al (2014) Relationship between margin distance and local recurrence among patients undergoing wedge resection for small (≤ 2 cm) non-small cell lung cancer. J Thorac Cardiovasc Surg 147:1169–1177CrossRefPubMed Mohiuddin K, Haneuse S, Sofer T et al (2014) Relationship between margin distance and local recurrence among patients undergoing wedge resection for small (≤ 2 cm) non-small cell lung cancer. J Thorac Cardiovasc Surg 147:1169–1177CrossRefPubMed
11.
go back to reference Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMed Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMed
12.
go back to reference Lewis RJ, Caccavale RJ, Sisler GE et al (1992) Video-assisted thoracic surgical resection of malignant lung tumors. J Thorac Cardiovasc Surg 104:1679–1687PubMed Lewis RJ, Caccavale RJ, Sisler GE et al (1992) Video-assisted thoracic surgical resection of malignant lung tumors. J Thorac Cardiovasc Surg 104:1679–1687PubMed
13.
go back to reference Clavein PA, Barkun J, Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications. Ann Surg 250:187–196CrossRef Clavein PA, Barkun J, Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications. Ann Surg 250:187–196CrossRef
14.
go back to reference Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48:452–458CrossRefPubMed Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48:452–458CrossRefPubMed
15.
go back to reference Rosen JE, Keshava HB, Yao X et al (2016) The natural history of operable non-small cell lung cancer in the national cancer center database. Ann Thorac Surg 101:1850–1855CrossRefPubMed Rosen JE, Keshava HB, Yao X et al (2016) The natural history of operable non-small cell lung cancer in the national cancer center database. Ann Thorac Surg 101:1850–1855CrossRefPubMed
16.
go back to reference Olsen GN (2000) Pulmonary physiologic assessment of operative risk. In: Shields TW, LoCicero III, Ponn RB (eds) General thoracic surgery, 5th edn. Lippincott Williams and Wilkins, Philadelphia, pp 297–313 Olsen GN (2000) Pulmonary physiologic assessment of operative risk. In: Shields TW, LoCicero III, Ponn RB (eds) General thoracic surgery, 5th edn. Lippincott Williams and Wilkins, Philadelphia, pp 297–313
17.
go back to reference Voltolini L, Bongiolatti S, Luzzi L et al (2013) Impact of interstitial lung disease on short-term and long-term survival of patients undergoing surgery for non-small-cell lung cancer: analysis of risk factors. Eur J Cardiothorac Surg 43:e17–e23CrossRefPubMed Voltolini L, Bongiolatti S, Luzzi L et al (2013) Impact of interstitial lung disease on short-term and long-term survival of patients undergoing surgery for non-small-cell lung cancer: analysis of risk factors. Eur J Cardiothorac Surg 43:e17–e23CrossRefPubMed
18.
go back to reference Zhai R, Yu X, Shafer A et al (2014) The impact of coexisting COPD on survival of patients with early-stage non-small cell lung cancer undergoing surgical resection. CHEST 145:346–353CrossRefPubMed Zhai R, Yu X, Shafer A et al (2014) The impact of coexisting COPD on survival of patients with early-stage non-small cell lung cancer undergoing surgical resection. CHEST 145:346–353CrossRefPubMed
19.
go back to reference Mimae T, Suzuki K, Tsuboi M et al (2015) Surgical outcomes of lung cancer in patients with combined pulmonary fibrosis and emphysema. Ann Surg Oncol 22:S1371–S1379CrossRefPubMed Mimae T, Suzuki K, Tsuboi M et al (2015) Surgical outcomes of lung cancer in patients with combined pulmonary fibrosis and emphysema. Ann Surg Oncol 22:S1371–S1379CrossRefPubMed
20.
go back to reference Sato T, Teramukai S, Kondo H et al (2014) Impact and predictors of acute exacerbation of interstitial lung disease after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg 147:1604–1611CrossRefPubMed Sato T, Teramukai S, Kondo H et al (2014) Impact and predictors of acute exacerbation of interstitial lung disease after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg 147:1604–1611CrossRefPubMed
21.
go back to reference Wolf AS, Swanson SJ, Yip R et al (2017) The impact of margins on outcomes after wedge resection for stage I non-small cell lung cancer. Ann Thorac Surg 104:1171–1178CrossRefPubMed Wolf AS, Swanson SJ, Yip R et al (2017) The impact of margins on outcomes after wedge resection for stage I non-small cell lung cancer. Ann Thorac Surg 104:1171–1178CrossRefPubMed
22.
go back to reference Chang JY, Senan S, Paul MA et al (2015) Stereotactic ablative radiotherapy versus lobectomy for operative stage I non-small-cell lung cancer: a pooled analysis of two randomized trials. Lancet Oncol 16:630–637CrossRefPubMedCentralPubMed Chang JY, Senan S, Paul MA et al (2015) Stereotactic ablative radiotherapy versus lobectomy for operative stage I non-small-cell lung cancer: a pooled analysis of two randomized trials. Lancet Oncol 16:630–637CrossRefPubMedCentralPubMed
23.
go back to reference Nagata Y, Hiraoka M, Shibata T et al (2015) Prospective trials of stereotactic body radiation therapy for both operative and inoperative T1N0M0 Non-small cell lung cancer: Japan clinical oncology group study JCOG0403. Int J Radiat Oncol Biol Phys 93:989–996CrossRefPubMed Nagata Y, Hiraoka M, Shibata T et al (2015) Prospective trials of stereotactic body radiation therapy for both operative and inoperative T1N0M0 Non-small cell lung cancer: Japan clinical oncology group study JCOG0403. Int J Radiat Oncol Biol Phys 93:989–996CrossRefPubMed
24.
go back to reference Lindeman NI, Cagle PT, Beasley MB et al (2013) Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: guideline from the college of American pathologists, international association for the study of lung cancer, and association for molecular pathology. J Thorac Oncol 8:823–859CrossRefPubMedCentralPubMed Lindeman NI, Cagle PT, Beasley MB et al (2013) Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: guideline from the college of American pathologists, international association for the study of lung cancer, and association for molecular pathology. J Thorac Oncol 8:823–859CrossRefPubMedCentralPubMed
25.
go back to reference Jeremic B, Bamberg M (2002) External beam radiation therapy for bronchial stump recurrence of non-small-cell lung cancer after complete resection. Radiother Oncol 64:251–257CrossRefPubMed Jeremic B, Bamberg M (2002) External beam radiation therapy for bronchial stump recurrence of non-small-cell lung cancer after complete resection. Radiother Oncol 64:251–257CrossRefPubMed
26.
go back to reference Takeda A, Suzuki N, Eriguchi T et al (2013) Salvage stereotactic ablative irradiation for isolated postsurgical local recurrence of lung cancer. Ann Thorac Surg 96:1776–1782CrossRefPubMed Takeda A, Suzuki N, Eriguchi T et al (2013) Salvage stereotactic ablative irradiation for isolated postsurgical local recurrence of lung cancer. Ann Thorac Surg 96:1776–1782CrossRefPubMed
27.
go back to reference Ajmani GS, Wang CH, Kim KW et al (2018) Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer. J Thorac Cardiovasc Surg 156:380–391CrossRefPubMed Ajmani GS, Wang CH, Kim KW et al (2018) Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer. J Thorac Cardiovasc Surg 156:380–391CrossRefPubMed
28.
go back to reference Sverzellati N, Guerci L, Randi G et al (2011) Interstitial lung disease in a lung cancer screening trial. Eur Respir J 38:392–394CrossRefPubMed Sverzellati N, Guerci L, Randi G et al (2011) Interstitial lung disease in a lung cancer screening trial. Eur Respir J 38:392–394CrossRefPubMed
Metadata
Title
Prognostic impact of underlying lung disease in pulmonary wedge resection for lung cancer
Authors
Takeshi Kawaguchi
Noriyoshi Sawabata
Sachiko Miura
Norikazu Kawai
Motoaki Yasukawa
Takashi Tojo
Shigeki Taniguchi
Publication date
01-04-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 4/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-018-1367-3

Other articles of this Issue 4/2019

International Journal of Clinical Oncology 4/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine